Patient description: The patient is a 47-year-old Asian woman complaining of persistent feelings of sadness. She lost interest in activities she used to enjoy. She states that her mood is mostly depressed for the past 3 weeks. She also lost her appetite , which led to about 5kg weight loss. She complains of loss of energy and feelings of worthlessness nearly every day. She is not using any drugs and she does not smoke. She doesn't drink alcohol. She used to exercise every day for at least 30 min. But she doesn't have enough energy to do so for the past 3 weeks. She also has some digestive issues recently. She is married and has 4 children. She is menopausal. Her husband was recently diagnosed with colon cancer and he is starting his chemotherapy. There is nothing remarkable in her past medical history and her drug history is only positive for Vit D3 1000 units daily. Her family history is negative for any psychologic problems. Her HAM-D score is 20.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Metastatic Hepatocellular Carcinoma Hepatocellular Carcinoma Patients must have histopathological confirmation of FLC by the NCI Laboratory of Pathology Patients must have disease that is not amenable to potentially curative resection, transplantation or ablation Patients must be greater than or equal to 18 years of age. Children are excluded from this study because this study has two mandatory biopsies performed for research purposes only and we do not want to put children into additional risk of biopsies Patients must have evaluable or measurable hepatic disease per 1.1 Patients must have hepatic lesion accessible for biopsy and be willing to undergo pre- and post-treatment mandatory biopsies ECOG performance status of less than or equal to 2 Adequate renal function defined by Creatinine <1.5 x institution upper limit of normal (ULN) Creatinine clearance (CrCl) greater than or equal to 50 mL/min/1.73 m2 by 24 hours urine collection or eGFR as estimated using the chronic kidney disease (CKD)-EPI equation for participant with creatinine levels > 1.5 X institutional ULN Adequate hepatic function defined by  Patients who have had standard-of-care anti-cancer therapy (e.g., chemotherapy,immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies or other investigation agents) within 2 weeks of enrollment; or, therapy with investigational agents, large field radiotherapy, or major surgery within 4 weeks prior to enrollment Patients who are currently receiving any other investigational agents for any indication Patients who are actively receiving broad-spectrum antibiotics or have received such within 4 weeks prior to enrollment Patients with history of recurrent C. diff colitis Patients who are on anti-coagulation or anti-platelet medication that cannot be interrupted prior to study-specified biopsies, including Aspirin that cannot be discontinued for 7 days prior to biopsy Clopidogrel and ticagrelor that cannot be discontinued for 5 days prior to biopsy Ticlopidine that cannot be discontinued for 10 days prior to biopsy Prasugrel that cannot be discontinued for 7 days prior to biopsy Dipyridamole that cannot be discontinued for at least 2 days prior to biopsy