[Hepatocellular Carcinoma: New multimodal therapy concepts]

Hepatocellular carcinoma guidelines are currently under revision. A new edition is expected in 2018. Patients with chronic liver diseases or cirrhosis require HCC screening by ultrasound every 6 months. Surgical resection or liver transplantation are curative treatment options for early stage HCC.

A more and more common and well tolerated locoregional therapy approach based on study data is selective internal radio therapy (SIRT), although studies did not show an improvement in outcome comparing SIRT to transarterial chemotherapy (TACE) in BCLC B or sorafenib in BCLC C.

Looking at targeted therapies regorafenib is approved for patients under treatment with sorafenib and disease progression as a second line therapy. Positive phase III-study data have been published for lenvatinib as first-line and cabozantinib as second-line therapy. Nivolumab was approved by the FDA as second-line therapy after positive phase I/II-study outcomes. A study on nivolumab versus sorafenib as first-line therapy will be published in 2018.