Patients with hepatocellular carcinoma (HCC) frequently show early recurrence even after hepatic resection and local ablation therapy. Moreover, many patients exhibit multiple HCC with or without distant metastasis at the time of initial diagnosis. Accordingly, to improve the overall survival of patients with HCC, effective systemic treatment, including chemotherapy, is needed. No agent has reproducibly documented a high response rate, and few chemotherapeutic regimens show meaningful impact on patient survival. Numerous clinical trials have been conducted to establish effective treatment for patients with HCC.