Objective To explore the clinical effects of targeted therapy with anlotinib in patients with intermediate to advanced hepatocellular carcinoma who had poor results with sorafenib treatment. Methods Twenty patients with intermediate to advanced hepatocellular carcinoma admitted to a hospital in Henan Province from August 2018 to October 2019 were selected for the study. Patients were given oral anlotinib 12 mg

1 time/d

for 14 d and then stopped for 1 week. 21 d was 1 course of treatment. Patients were reviewed every 6 weeks by CT or MRI to evaluate the efficacy

and the treatment effect was judged according to the maximum diameter of the target lesion measured by CT or MRI. The patients were observed for treatment effect

survival

and occurrence of adverse effects. Results One case（5%） achieved partial remission（PR）

9 cases（45%） had stable disease（SD）

and 10 cases（50%） showed disease progression（PD）. Progression-free survival（PFS） was 4.2 months（95% CI:2.8-5.7 months） and overall survival（OS） was 9.6 months（95% CI:8.5-10.6 months）. There were no treatment discontinuations due to serious adverse reactions

and no treatment-related deaths were observed. The adverse reactions were hand-foot syndrome（4/20

20%）

hypertension（6/20

30%）

proteinuria（3/20

15%）

malaise（9/20

45%）

diarrhea（3/20

15%）

and gastrointestinal bleeding（1/20

5%）

and all were effectively controlled with symptomatic treatment. Conclusion Anlotinib monotherapy given to patients with intermediate to advanced hepatocellular carcinoma who had poor results with sorafenib had significant clinical effects

low incidence of adverse events

and long survival

and can be used as a choice of post-line therapy for patients with intermediate to advanced hepatocellular carcinoma.