In very rapidly progressive/poorly differentiated hepatocellular cancer, would you use the targeted options (sorafenib/lenvatinib) or would you try a traditional cytotoxic regimen?   

The approach to a patient with rapidly progressive hepatocellular cancer is quite challenging.  Systemic chemotherapy is of marginal benefit in this disease.  Years ago we utilized adriamycin, largely because there were no other agents!  We should have learned from studies, albeit ear...