Current and future treatments for hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) represents a unique challenge for physicians and patients. There is no definitively curative treatment. Rather, many treatment and management modalities exist with differing advantages and disadvantages. Both current guidelines and individual patient concerns must be taken into account in order to properly manage HCC. In addition, quality of life issues are particularly complex in patients with HCC and these concerns must also be factored into treatment strategies. Thus, considering all the options and their various pros and cons can quickly become complex for both clinicians and patients. In this review, we systematically discuss the current treatment modalities available for HCC, detailing relevant clinical data, risks and rewards and overall outcomes for each approach. Surgical options discussed include resection, transplantation and ablation. We also discuss the radiation modalities: conformal radiotherapy, yttrium 90 microspheres and proton and heavy ion radiotherapy. The biologic agent Sorafenib is discussed as a promising new approach, and recent clinical trials are reviewed. We then detail currently described molecular pathways implicated in the initiation and progression of HCC, and we explore the potential of each pathway as an avenue for drug exploitation. We hope this comprehensive and forward-looking review enables both clinicians and patients to understand various options and thereby make more informed decisions regarding this disease.

IFI16 restoration in hepatocellular carcinoma induces tumour inhibition via activation of p53 signals and inflammasome

“…Currently, the treatments for HCC are limited including surgery, radiotherapy or chemotherapy, especially for patients with advanced disease who are not eligible for curative hepatectomy or hepatic transplantation. Diagnosis at late stage is the most important reason and the high rate of recurrence also leads to the low 5‐year survival of HCC patients with <40% . Thus, understanding the potential mechanisms of HCC pathogenesis is critical for the diagnosis at early stage and effectively new treatment.…”

Potential Molecular Targets and Drugs for Treatment of Hepatocellular Carcinoma

“…In the recent years, a large number of new molecularly targeted agents have been investigated, including inhibitors of EGFR, IGFR, HGF/c-Met linked pathways, and angiogenesis inhibitors [10]. In addition, inhibitors of intracellular signaling pathways like MAPK, mTOR are also under investigation [81].…”

Mucin 1 promotes radioresistance in hepatocellular carcinoma cells through activation of JAK2/STAT3 signaling

“…The majority of patients with HCC are diagnosed at an advanced disease stage and are not amenable to potentially curative therapies, including surgery, transplantation, and radiofrequency ablation (3). Several therapies, including transarterial chemoembolization and radiation therapy are currently available for patients with locally advanced HCC (4).…”