Systemic Therapy for Hepatocellular Carcinoma: Current Updates and Outlook.

Area of Science:

• Hepatology and Oncology
• Translational Medicine

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality globally.
• Significant advancements in systemic therapy have improved outcomes for advanced HCC (aHCC).

Purpose of the Study:

• To review recent updates in systemic therapy for HCC based on biological mechanisms.
• To highlight approved agents, combination therapies, and adjuvant/neoadjuvant strategies for aHCC.

Main Methods:

• Literature review of recent clinical trials and therapeutic advancements in HCC.
• Analysis of targeted therapies, immunotherapies, and combination regimens.
• Exploration of traditional Chinese medicine (TCM) in HCC systemic therapy.

Main Results:

• Targeted agents (sorafenib, lenvatinib, etc.) and immunotherapies (pembrolizumab, nivolumab) are established treatments for aHCC.
• Combination therapies (atezolizumab/bevacizumab, ipilimumab/nivolumab) show promise in first- and second-line settings.
• Adjuvant, neoadjuvant, and combined locoregional therapies (LRTs) are discussed, alongside TCM's potential.

Conclusions:

• Systemic therapy for HCC has evolved significantly, offering improved survival for patients with advanced disease.
• Combination strategies and novel agents represent the future of HCC treatment.
• Further research into TCM and integrated approaches is warranted.