Sorafenib and entecavir: the dioscuri of treatment for advanced hepatocellular carcinoma?

Hepatitis B virus (HBV) is responsible for 50%-80% of cases of hepatocellular carcinoma (HCC) worldwide. Entecavir (ET) is a potent inhibitor of chronic HBV-DNA polymerase, inhibiting both the priming and elongation steps of viral DNA replication. Sorafenib (SO) has proven efficacy in prolonging survival in patients with advanced HCC. In this frontier report we discuss a possible way to optimize treatment outcomes in patients with HBV and HCC by treatment with ET and SO, on the basis of our practice and published evidence from the literature.