肝细胞癌（HCC）常呈晚期发现，预后差且死亡率高。对于晚期疾病，系统治疗是治疗的选择。2007年，第一代多激酶抑制剂（MKI）索拉非尼获批并证实对总生存期（OS）能略微延长。直至2018年，另外一种MKI，利伐替尼，展示出与索拉非尼在HCC一线治疗中中位OS相当的非劣效。此后，在2017年至2019年间，针对HCC的二线靶向治疗（如雷戈非尼、卡波替尼和拉莫单抗）取得显著进展。人们开始更加关注通过靶向细胞程序性死亡-1（PD-1）、其配体PD-L1以及细胞毒性T淋巴细胞相关蛋白4来抑制免疫检查点的免疫检查点抑制剂（ICIs）。这些ICIs已经在HCC初次和随后的治疗中展现出了其强效。目前，根据积极的三期临床试验结果，阿特佐利单抗联合贝伐单抗以及曲美替单抗和杜伐沙单抗联合治疗被推荐作为一线治疗方案。随着ICIs的发展，MKIs在HCC治疗中的作用预计将发生变化。本文选择了在HCC中最常用的MKIs之一——利伐替尼进行综述。

Hepatocellular carcinoma (HCC) frequently presents as advanced stage with poor prognosis and high mortality. Systemic treatment is the treatment of choice for advanced disease. In 2007, the first multi-kinase inhibitor (MKI) sorafenib was approved and shown to modestly prolong overall survival (OS). The progress of systemic therapy has been slow afterwards until 2018 when lenvatinib, another MKI, was shown to be non-inferior to sorafenib on median OS as the first-line therapy for HCC. Since then, remarkable progress has been achieved on the treatment of advanced HCC, including the development of second-line targeted treatment, including regorafenib, cabozantinib and ramucirumab from 2017 to 2019. A growing focus has been placed on immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD- 1), its ligand PD-L1, and cytotoxic T-lymphocyte-associated protein 4. These ICIs have proven their potency in treating HCC as both initial and subsequent line of therapy. At present, both regimens of atezolizumab combined with bevacizumab, as well as the combination of tremelimumab and durvalumab, are recommended as the first-line treatments based on positive phase III clinical trials. With the advancement of ICIs, it is anticipated that the role of MKIs in the treatment of HCC will evolve. In this article, lenvatinib, one of the most commonly used MKIs in HCC, is chosen to be reviewed.