Chemoembolization With or Without Sorafenib Tosylate in Treating Patients With Liver Cancer That Cannot Be Removed by Surgery

Inclusion Criteria:

• Patients must have a diagnosis of hepatocellular carcinoma by at least one criterion listed below:

• Histologically confirmed

• Magnetic resonance imaging (MRI) or computerized tomography (CT) consistent with liver cirrhosis AND at least one solid liver lesion > 2 cm with early enhancement and delayed enhancement washout regardless of alpha-feto protein levels (AFP)

• AFP > 400 ng/mL AND evidence of at least one solid liver lesion > 2 cm regardless of specific imaging characteristics on CT or MRI

• Patients must have hepatocellular carcinoma (HCC) limited to the liver; there must be no clinical or radiographic evidence of extrahepatic HCC

• Portal lymphadenopathy IS permitted for patients with hepatitis B virus (HBV) or hepatitis C virus (HCV) - as lymphadenopathy is commonly associated with hepatitis unrelated to malignancy

• Staging CT of the chest and CT or MRI of the abdomen and pelvis must have been completed within 4 weeks of study registration

• Patients must have measurable disease constituting < 50% of liver parenchyma within 4 weeks of registration

• Patients may not have ascites detectable on physical examination

• Patients must not be candidates for curative resection, orthotopic liver transplantation, or radiofrequency ablation (RFA)

• Patients may have been treated with RFA in the past, but no sooner than 4 weeks before study registration

• Patients may have undergone previously attempted curative liver resection

• Patients may NOT have been previously treated with brachytherapy such as yttrium-90 microsphere

• Patients may NOT have been previously treated with sorafenib, chemoembolization, or systemic chemotherapy including cytotoxic agents or molecularly targeted agents

• Branch portal vein invasion by tumor is permitted but patients with main portal vein invasion by tumor are not eligible

• Patients must have Child-Pugh score of A or B7 within 4 weeks prior to study registration

• Serum total bilirubin =< 2.0 mg/dL

• Alkaline phosphatase < 5 x upper limit of normal (ULN)

• Aspartate aminotransferase (AST), alanine aminotransferase (ALT) < 5 x ULN

• Serum creatinine =< 1.5 mg/dL

• Platelet count >= 50,000/mm^3

• Patients must not have any evidence of bleeding diathesis or active gastrointestinal bleeding

• Patients must have no clinical signs of heart failure and meet New York Heart Association functional classification I or II defined as:

• Class I - patients with no limitation of activities; they suffer no symptoms from ordinary activities

• Class II - patients with slight, mild limitation of activity; they are comfortable with rest or with mild exertion

• Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

• Patients must have a life expectancy of at least 3 months

• Patients must not be known to be human immunodeficiency virus (HIV) positive

• Patients must not have other uncontrolled intercurrent illnesses excluding HBV or HCV, including, but not limited to: uncontrolled hypertension, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia or psychiatric illness/addictive disorders that would limit compliance with study requirements

• Uncontrolled hypertension is defined as optimally treated baseline blood pressure that exceeds 150/90 mm Hg

• Patients must not be taking cytochrome P450 enzyme inducing drugs

• Age >= 18 years

• Women must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy

• Women of childbearing potential and sexually active males must be strongly advised to use an accepted and effective method of contraception

• Patients must not have an allergy to iodine or gadolinium contrast that cannot be safely controlled with premedication

• Patient must be able to swallow pills, as study medications cannot be crushed