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Systemic treatment of advanced hepatocellular cancer: new hope on the horizon
Rachael Chang Lee1, Niall Tebbutt1
1a Department of Medical Oncology , Olivia Newton-John Cancer Wellness and Research Centre , Heidelberg , Australia.
Introduction:
Hepatocellular carcinoma (HCC) is among the leading causes of cancer-related mortality in the world. The majority of the patients present at an advanced or incurable stage where neither locoregional treatment nor combination treatment of locoregional treatment and systemic therapies is feasible. For decades sorafenib was the only treatment option available for advanced HCC. However, with the advent of new and more effective therapies recently, the overall prognosis of advanced HCC has improved significantly. Areas covered: This review summarises the current systemic treatment options available and future prospects in the management of advanced HCC where patients are not suitable for locoregional treatment. Expert opinion: New effective targeted therapeutics have dramatically changed the treatment landscape for advanced HCC. The incorporation of sequential therapy including sorafenib or lenvatinib as first-line treatment and immunotherapy, regorafenib or cabozantinib as second-line treatment have significantly improved outcomes for patients with advanced HCC. Further development of novel combinations of these new agents and predictive/prognostic biomarkers are being explored. Efforts should also be made to tailor treatment to individual patients based on etiology, clinical and molecular factors.
Insights
New targeted therapies have significantly improved outcomes for advanced hepatocellular carcinoma (HCC) patients. Sequential treatments combining targeted agents and immunotherapy offer better prognoses for advanced HCC, with ongoing research into novel combinations and personalized medicine.
Area of Science:
- Hepatology
- Oncology
- Pharmacology
Background:
- Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality globally.
- Many patients are diagnosed at advanced stages, precluding locoregional treatments.
- Sorafenib was the sole treatment for advanced HCC for many years.
Purpose of the Study:
- To review current systemic treatment options for advanced HCC in patients ineligible for locoregional therapy.
- To discuss future prospects in advanced HCC management.
Main Methods:
- This is a review article.
- It summarizes current systemic therapies and future directions.
- Expert opinion is included.
Main Results:
- New targeted therapeutics have transformed advanced HCC treatment.
- Sequential therapies (sorafenib/lenvatinib first-line, immunotherapy/regorafenib/cabozantinib second-line) improve outcomes.
- Novel combinations and biomarkers are under investigation.
Conclusions:
- Advanced HCC treatment has significantly improved due to new systemic therapies.
- Personalized treatment approaches considering etiology and molecular factors are crucial.
- Further research into novel combinations and biomarkers is warranted.
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