Based on the elevated AFP and CT findings, the patient was considered to have relapsed metastatic HCC. He was started on standard therapy with sorafenib 200 mg orally twice a day for a week, then 400 mg orally twice a day... After five months of therapy with sorafenib, AFP increased from 2751 mcg/L to 8877 mcg/L...After informed consent to individual therapy, off-label treatment with the anti-PD-1 antibody pembrolizumab (2 mg/kg every three weeks) was initiated. After six cycles of therapy, a CT scan of the abdomen showed a major decrease in subxiphoid mass size from 8 x 6 cm to 4 x 1.6 cm (Figure ​(Figure2)2) and AFP dropped from 8877 mcg/L to 1.7 mcg/L. The patient tolerated therapy with pembrolizumab without adverse effects...