APASL clinical practice guidelines on systemic therapy for hepatocellular carcinoma-2024

Area of Science:

• Hepatobiliary cancers
• Medical oncology
• Clinical practice guidelines

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer death in the Asia-Pacific, with high incidence and unmet needs in managing recurrence and disease progression.
• Current treatment challenges include recurrence post-curative therapies and progression in unresectable HCC cases.
• Recent advancements include targeted therapies and immune-checkpoint inhibitors as systemic treatments.

Purpose of the Study:

• To provide updated clinical practice recommendations for hepatocellular carcinoma (HCC) management.
• To address key questions regarding patient selection, therapy choice, and monitoring for systemic HCC treatment.
• To synthesize evidence and expert experience from Asia-Pacific key opinion leaders.

Main Methods:

• Development of a clinical practice guideline based on current clinical evidence.
• Expert consensus from Asia-Pacific key opinion leaders in HCC.
• Focus on systemic therapy, including targeted agents and immune-checkpoint inhibitors.

Main Results:

• New systemic therapies are available for first- and second-line treatment of unresectable HCC.
• Emerging data supports systemic therapy for preventing HCC recurrence and managing post-locoregional therapy progression.
• Insights into immune-related adverse events aid in optimizing immunotherapy approaches.

Conclusions:

• Systemic therapies, particularly immune-checkpoint inhibitors, are poised to transform HCC management.
• Guidelines are essential for selecting appropriate patients and therapies, and for monitoring treatment.
• Optimized management strategies are crucial for improving outcomes in hepatocellular carcinoma.