Transarterial chemoembolization (TACE) and sorafenib have both been shown to prolong survival in patients with unresectable hepatocellular carcinoma (HCC), but previous trials assessing the combination of TACE and sorafenib have been unable to show clinical benefit compared with TACE alone. Now, Kudo et al. report results from a randomized, multicentre prospective trial of TACE plus sorafenib compared with TACE alone in patients with unresectable HCC. Patients were randomized either to treatment with TACE plus sorafenib before and after TACE (n = 80) or to a group that received TACE without addition of sorafenib (n = 76). Median progression-free survival was significantly longer (P = 0.006) in the combination group (25.2 months) than in the TACE without sorafenib group (13.5 months). Median time to untreatable progression (a TACE-specific endpoint) was also significantly longer (P = 0.02) in the combination group (26.7 months) than in the TACE without sorafenib group (20.6 months).