Sorafenib Tosylate and Chemoembolization in Treating Patients With Unresectable Liver Cancer

Inclusion

* Histologically confirmed hepatocellular carcinoma
* AND/OR Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) consistent with liver cirrhosis AND at least one solid liver lesion \> 2cm with arterial-phase enhancement and delayed washout regardless of alpha-feto protein levels (AFP)
* AND/OR AFP \> 400ng/mL AND evidence of at least one solid liver lesion \> 2cm regardless of specific imaging characteristics on CT or MRI
* Patient is not a candidate for transplantation, resection, or ablation; for whom the intended therapy is chemoembolization
* Patient meets clinical criteria for treatment with chemoembolization
* Absolute contraindications to chemoembolization include an uncorrectable bleeding disorder, uncorrectable contrast sensitivity, leukopenia (white blood cell count \< 1000/uL), cardiac or renal insufficiency (serum creatinine \> 2.0mg/dL), hepatic encephalopathy, jaundice, or dilated intrahepatic bile ducts
* Portal vein occlusion is a relative contraindication and chemoembolization can be performed only if there are collateral vessels with hepato-pedal flow demonstrated angiographically
* Hepatic compromise as determined by the following combination of parameters is a contraindication to therapy: lactate dehydrogenase \> 425 U/L, aspartate aminotransferase \> 100 U/L, total bilirubin \> 2.0 mg/dL and \> 50% liver volume replaced by tumor
* Patients may have been treated with ablation or resection in the past, but no sooner than 4 weeks before study registration
* Patients may NOT have been previously treated with sorafenib, chemoembolization, radioembolization, or systemic chemotherapy with cytotoxic agents or molecularly targeted agents
* ECOG performance status =\< 2
* Life expectancy of greater than 3 months
* Platelets \>= 50,000/mcL
* Total bilirubin =\< 2.0 mg/dl
* AST(SGOT)/ALT(SGPT) =\< 3X institutional upper limit of normal
* Creatinine =\< 1.5 mg/dl
* INR =\< 1.5
* 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

* Because agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation
* Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
* Ability to understand and the willingness to sign a written informed consent document

Exclusion

* Patients may not be receiving any other investigational agents
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to sorafenib
* History of radiologic contrast reactions not controlled by standard premedications
* Patients must not be taking cytochrome P450 enzyme inducing drugs
* Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, uncontrolled hypertension, or psychiatric illness/social situations that would limit compliance with study requirements
* Pregnant women are excluded from this study
* Breastfeeding should be discontinued
* Prophylactic use of G-CSF or GM-CSF is not permitted on this trial