Inclusion Criteria:

- Histologically or cytologically confirmed hepatocellular carcinoma

- Unresectable, locally advanced, or metastatic disease

- Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by
conventional techniques OR ≥ 10 mm by spiral CT scan

- Child's Pugh score A5, A6, B7, or B8

- No known brain metastases

- No history of primary CNS tumors

- ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%

- Life expectancy > 3 months

- Leukocytes ≥ 3,000/mcL

- Absolute neutrophil count ≥ 1,500/mcL

- Platelet count ≥ 75,000/mcL

- Total bilirubin ≤ 2 times upper limit of normal (ULN)

- AST/ALT ≤ 2.5 times ULN

- PT/INR ≤ 1.7 times ULN

- Creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min

- Fasting serum glucose ≤ 125 mg/dL

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No clinical encephalopathy

- No history of allergic reactions attributed to compounds of similar chemical or
biologic composition to anti-IGF-1R recombinant monoclonal antibody IMC-A12

- No poorly controlled diabetes mellitus

- Patients with a history of diabetes mellitus are eligible provided their blood
glucose is within normal range (fasting blood glucose < 120 mg/dL OR below ULN)
and patient is on a stable dietary or therapeutic regimen for this condition

- No concurrent uncontrolled illness including, but not limited to, any of the
following:

- Ongoing or active infection

- Symptomatic congestive heart failure

- Unstable angina pectoris

- Cardiac arrhythmia

- Psychiatric illness or social situation that would preclude compliance with
study requirements

- No history of seizures not well controlled with standard medical therapy

- No history of stroke

- No history of another primary cancer except for the following:

- Curatively resected nonmelanoma skin cancer

- Curatively treated carcinoma in situ of the cervix

- Other primary solid tumor with no known active disease present that in the
opinion of the investigator would not affect treatment outcome

- Prior local therapy (i.e., surgery, radiotherapy, hepatic arterial embolization,
radiofrequency ablation, percutaneous ethanol injection, or cryoablation) allowed
provided the target lesion has not been treated with local therapy and/or the target
lesion within the field of local therapy has shown an increase of ≥ 25% in size

- At least 4 weeks since prior local therapy

- No prior systemic therapy except for sorafenib tosylate

- No prior agents targeting the IGF or IGF-1R pathway

- No concurrent combination antiretroviral therapy for HIV-positive patients

- No other concurrent investigational agents

- No concurrent anticancer therapy