Novel systemic treatment for hepatocellular carcinoma: a step-by-step review of current indications

Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the main cause of cancer-related death worldwide. The available treatment options for HCC include liver transplant, locoregional therapy (such as ablation, embolization, and radiotherapy), and systemic treatment. The latter encompasses targeted therapy, immunotherapy, and angiogenesis inhibitors, alone or in combination. The introduction of immune checkpoint inhibitors and targeted drug therapy has been one of the most significant advances in HCC treatment. These therapies were shown to prolong overall survival and progression-free survival in clinical trials including patients with advanced HCC. In recent years, the systemic treatment of advanced HCC has vastly improved, with a median survival of 19.2 months in the IMbrave150 trial. However, further research is needed to determine the optimal sequence of treatment.

Long-term survival and remarkably durable treatment response in a case of inoperable fibrolamellar carcinoma of the liver — a comprehensive analysis of an 8-year chemotherapeutic journey

“…Shortly afterward, the drug was exchanged for regorafenib, which had not been administered earlier due to its unavailability in the European Union before 2017 [40]. Regorafenib, despite its similarity to sorafenib, was shown to be more effective in consecutive HCC treatment lines [41,42]. The patient's response to the rechallenge of multikinase inhibitors was definitely surprising.…”