We read the Article on the TransMet trial by René Adam and colleagues with great enthusiasm. The results are unprecedented, with a staggering 5-year overall survival of 56·6% (95% CI 43·2−74·1) in the liver transplantation plus chemotherapy group compared with 12·6% (5·2–30·1) in the chemotherapy alone group. However, we question whether it is too early to say that the unmet need in patients with unresectable liver-only disease has been addressed.