[Hepatocellular Carcinoma: New multimodal therapy concepts]

Area of Science:

• Hepatology and Oncology
• Clinical Trial Research

Background:

• Current hepatocellular carcinoma (HCC) guidelines are under revision, with a new edition anticipated in 2018.
• Regular screening via ultrasound every six months is recommended for patients with chronic liver diseases or cirrhosis.
• Early-stage HCC is curable with surgical resection or liver transplantation.

Purpose of the Study:

• To review current and emerging treatment strategies for hepatocellular carcinoma (HCC).
• To highlight advancements in locoregional and systemic therapies for HCC management.

Main Methods:

• Review of published studies and clinical trial data on HCC treatments.
• Analysis of guideline revisions and therapeutic approvals.

Main Results:

• Selective internal radiotherapy (SIRT) is a well-tolerated locoregional therapy but has not shown outcome improvement over TACE or sorafenib in specific BCLC stages.
• Regorafenib is approved as second-line therapy post-sorafenib.
• Lenvatinib and cabozantinib show positive data as first- and second-line therapies, respectively.
• Nivolumab is FDA-approved for second-line therapy, with ongoing trials comparing it to sorafenib in the first-line setting.

Conclusions:

• The treatment landscape for HCC is evolving with new systemic therapies offering improved options.
• While locoregional therapies like SIRT are established, their comparative efficacy requires further investigation.
• Ongoing research and guideline updates are crucial for optimizing HCC patient management.