Single Arm, Non Randomized Phase II Trial of Gemcitabine and Oxaliplatin (GEM-OX) for Hepatocellular Carcinoma (HCC) Patients With Platelet Counts Greater Than 100,000 Per Microliter.

Inclusion Criteria:

- All patients 18 years of age or older, with hepatocellular carcinoma are eligible.

- Patients must have a life expectancy of at least 12 weeks.

- Patients must have a ECOG performance status of 0-2.

- Patients must sign an informed consent.

- Patients should have adequate bone marrow function defined by an absolute peripheral
granulocyte count of > 1,500 or cells/mm3 and platelet count >100,000/mm3 and absence
of a regular red blood cell transfusion requirement.

- Patients should have adequate hepatic function with a total bilirubin < 2 mg/dl and
SGOT or SGPT < two times the upper limit of normal, and adequate renal function as
defined by a serum creatinine < 1.5 x upper limit of normal.

- There must be one measurable lesion according to the RECIST criteria that should not
have had prior radiation treatment.

Exclusion Criteria:

- Patients with symptomatic brain metastases that had not been adequately and
definitively treated with radiation and/or surgical resection are excluded from this
study.

- Pregnant women or nursing mothers are not eligible for this trial. Patients of child
bearing potential must use adequate contraception.

- Patients may receive no other concurrent chemotherapy or radiation therapy during
this trial.

- Patients with severe medical problems such as uncontrolled diabetes mellitus or
cardiovascular disease or active infections are not eligible for this trial.

- Life expectancy of less than 12 weeks.

- Serious, uncontrolled concurrent infection(s)

- Any prior treatment with, Gemcitabine or Oxaliplatin .

- Completion of previous chemotherapy regimen less than 4 weeks, prior to start of this
study or persistence of prior treatment related toxicity.

- Treatment for other carcinomas within the last five years, except for cured
non-melanoma of the skin and treated in-situ cervical cancer.

- Participation in any investigational study within 4 weeks preceding the start of the
study treatment.

- Clinically significant heart disease defined as NYHA class 3 or 4 heart disease.

- Chronic debilitating diseases that the investigator feels might compromise the study
Participation.

- Evidence of inadequately treated CNS metastases.

- Major surgery within 4 weeks of the s1art of the study treatment without complete
recovery.

- Known or existing uncontrolled coagulopathy.

- Any of the following laboratory parameters v) Abnormal hematological values with ANC
less than 1500/mm3, thrombocytopenia less than 99,000. vi) Impaired renal function
with a serum creatinine of greater than 1.5 ULN vii) Serum bilirubin greater than
1.5xULN viii) Albumin less than 2.5mg/dl.

- Unwillingness to give informed consent.

- Unwillingness to participate or inability to comply with the protocol for the
duration of the study.