Liver cancer, mostly hepatocellular carcinoma (HCC), is the second leading cause of cancer mortality globally. Most patients were diagnosed at an advanced stage, and systemic therapy is the standard of care. All the approved systemic therapies for HCC are molecular targeted therapies with anti-angiogenic effects targeting the vascular endothelial growth factor signaling pathway. Sorafenib and lenvatinib are the first-line treatment, and regorafenib, ramucirumab, and cabozantinib are second-line treatment options. Although anti-PD-1 antibodies, including nivolumab and pembrolizumab, demonstrated promising anti-tumor effects as monotherapy for advanced HCC in phase II clinical trials, both failed in phase III studies. Anti-angiogenic treatment remains the backbone of systemic therapy for HCC. In this review, we summarized the approved anti-angiogenic medicines and discussed the potential strategies to improve the efficacy of anti-angiogenic therapy, including combination therapy with other treatments, and discussed the approaches to overcome the drawbacks of anti-angiogenic therapies.

肝癌，主要是肝细胞癌（HCC），是全球癌症死亡的第二大主要原因。大多数患者被诊断为晚期，全身治疗是护理的标准。所有批准的HCC全身疗法都是具有靶向血管内皮生长因子信号通路的抗血管生成作用的分子靶向疗法。索拉非尼和lenvatinib是一线治疗，而雷戈非尼，雷莫昔单抗和卡波替尼是二线治疗选择。尽管抗PD-1抗体（包括nivolumab和pembrolizumab）在II期临床试验中作为晚期HCC的单一疗法表现出令人鼓舞的抗肿瘤作用，但均在III期研究中失败。抗血管生成治疗仍然是HCC全身治疗的基础。在这篇评论中