Management of Advanced Hepatocellular Carcinoma: A Review and Practical Guide

Area of Science:

• Hepatology and Oncology
• Gastroenterology

Background:

• Global incidence and mortality of hepatocellular carcinoma (HCC) are rising.
• Epidemiologic risk factors are shifting from viral hepatitis to alcohol and metabolic dysfunction-associated steatotic liver disease.
• Systemic therapy is required for over half of advanced HCC patients.

Purpose of the Study:

• To provide a comprehensive overview of recent developments in systemic therapy for advanced HCC.
• To update practicing oncologists on the evolving treatment landscape.

Main Methods:

• Review of recent clinical trial data and therapeutic approvals.
• Analysis of the current role of molecular testing and liver function in HCC management.
• Discussion of novel systemic therapies under investigation.

Main Results:

• The treatment landscape for advanced HCC has significantly evolved with new approvals.
• Immune checkpoint inhibitors and tyrosine kinase inhibitors targeting angiogenesis have improved patient outcomes.
• Optimal sequencing of systemic agents remains undefined.

Conclusions:

• Systemic therapies have transformed advanced HCC management.
• Ongoing research is exploring novel treatment modalities like adoptive cell therapy.
• Further research is needed to define optimal treatment sequencing and the role of molecular testing.