Study procedures All laboratory tests will be conducted as normal with additional specific tests to be performed in Liver Disease Research Center (LDRC), or the Proteomics Lab, KSU-Riyadh. Blood will be collected in three 7ml tubes with each biopsy. cDNA microarray analysis will be done on the pathways acted on by Sorafenib, namely the MAP kinase pathway. The analysis will be done at LDRC, KSU-Riyadh. • Tissue samples will be obtained in all patients from the tumor under imaging guidance • Tumor tissue biopsies will be performed at baseline and at end-of-study/when study endpoint is met o A minimum of 3 cm of tumor tissue will be obtained (2-3 needle passes). o Transportation of samples to the LDRC will be done on dry ice. o Tissue obtained will be snap frozen at -800C until processing. o Tissue will be tested for genes involved in the RAF pathway. o Genetic expression from the fresh tumor tissue will be quantified using RT-PCR for mRNA quantification. Once upregulated genes are identified, their corresponding proteomic expression will be tested in the serum for potential serum markers. Proteomic testing will be performed using Mass Spectroscopy. Additional specific blood tests will be performed in LDRC. Blood will be collected in two 7 ml EDTA tubes (purple top) and one plain tube (red top). Blood samples will be collected at the same time with the liver biopsy. Blood once collected will be transported immediately to LDRC on dry ice and stored at -80oC. Samples will be thawed and data analysed when the individual patient has met study end-point or at study completion, as relevant. Liver biopsy samples will also be transported on dry ice to LDRC and snap-frozen at -80oC for subsequent analysis. Blood and tissue will be collected and transported by pre-arrangement with LDRC staff, and will be coordinated by the SOLID registrar (Nouf Alanezi) and/or the study CRC in KAMC-Riyadh. All patient-related data, including demographic, clinical, laboratory, and radiological data will be collected in the comprehensive HCC eCRF of the SOLID registry where appropriate. As a feature of the registry, all patient-related data is encoded in order to remove any patient identifiers. All blood samples stored for end-of-study investigations will be barcoded and the stickers tagged to the SOLID registry identifiers for easy retrieval.