Purpose Hypothesis: Epirubicin TACE (eTACE) is as safe and efficacious as TACE with doxorubicin DEB. This is relevant because eTACE is significantly less expensive than DEB TACE (AWP $296 vs $1537). Materials and Methods After IRB approval, retrospective review of patients undergoing eTACE from 1/1/2012- 9/1/2012 was conducted (coinciding with a nationwide shortage of doxorubicin). 77 patients with imaging diagnosis of HCC (20 women, 57 men; mean MELD 10, range 5-22) had 97 eTACE treatments using 50-100 mg of Epirubicin (Hospira), Lipiodol and gelfoam. After excluding those with prior doxorubicin DEB TACE, 41 had imaging and were analyzed by mRECIST to determine tumor response. Safety data was analyzed on all patients and outcomes were liver toxicity and serious adverse events (CTCAE v4.0). Results Note that in Table 1 the comparison trials reflect response following 2 treatments, nearly all of our patients had one treatment (except for 2 PD, 2 PR, and 1 CR had 2 treatments). In our population, 2 patients were downstaged for transplant and 3 maintained on waiting list; all 5 underwent transplant. eTACE was well tolerated, with mean hospital stay of 1 night. There was no liver toxicity at 1 month. There were 2 deaths in the study population: one from retroperitoneal bleed complications and one from declining liver function in a patient with prior DEB. Conclusion Early results show that eTACE is safe and efficacious for HCC. Long-term follow-up is needed to show durability of response and impact on survival.