Neoadjuvant systemic therapy for hepatocellular carcinoma.

Area of Science:

• Hepatobiliary Surgery
• Medical Oncology
• Hepatocellular Carcinoma Research

Background:

• Surgical resection and liver transplant are the primary curative treatments for hepatocellular carcinoma (HCC).
• Historically, systemic therapies for HCC have had limited efficacy.
• Recent advancements include immune checkpoint inhibitors and targeted therapies, offering new hope.

Purpose of the Study:

• To investigate the role and efficacy of neoadjuvant systemic therapy in patients with resectable or locally advanced HCC.
• To summarize findings from early-phase trials exploring novel systemic therapy combinations.
• To highlight the need for further research into long-term oncologic outcomes.

Main Methods:

• Review of completed and ongoing clinical trials involving neoadjuvant systemic therapy for HCC.
• Analysis of treatment combinations including immune checkpoint inhibitors, tyrosine kinase inhibitors, transarterial therapies, and radiation.
• Focus on early-phase trial results and ongoing investigations.

Main Results:

• Early-phase trials of neoadjuvant systemic therapy in HCC show encouraging results.
• Combinations of systemic therapies, transarterial therapies, and radiation are being actively investigated.
• Promising outcomes observed with immune checkpoint inhibitors and targeted therapies.

Conclusions:

• Neoadjuvant systemic therapy is a rapidly evolving area in HCC management.
• While early results are promising, larger trials are essential to establish long-term benefits.
• The optimal role of neoadjuvant systemic therapy in conjunction with curative intent treatments requires further definition.