Fig. 1

Treatment streams for all patients. Patients 1–17 are first-line sorafenib cases and 18–36 are first-line lenvatinib cases. Ramucirumab was administered as second, third, fourth, and fifth-line treatment in 13 (35.1%), 14 (37.8%), eight (21.6%), and two (5.4%) patients, respectively. The most common timing of ramucirumab administration was as second-line after lenvatinib in 11 (29.7%) patients. The longest duration of administration was 446 days (22 courses) and was third-line therapy after sorafenib and regorafenib. There was no consistent trend in the duration of ramucirumab treatment depending on the first-line drug and type of previous drug. In patient 2, the sorafenib administration period was 2,648 days; therefore, the bar indicating sorafenib administration period was shortened