Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide. Only 20-30% of patients are diagnosed at an early stage suitable for curative approaches, and the recurrence rate after curative treatment is high, with no proven adjuvant strategies. Trans-arterial (chemo)embolisation is the only treatment for intermediate stage HCC supported by data from randomised trials, and the angiogenic/multikinase inhibitors, sorafenib and regorafenib, currently represent the only standard options in the advanced disease setting. However, very recently novel targeted agents have succeeded in large randomised trials and promise to enrich the repertoire of available treatments for advanced HCC in the near future. In addition, early phase trials of immunotherapies have reported encouraging results in advanced HCC and the outcome of randomised studies are eagerly awaited. This review focuses on recent clinical and translational developments that have influenced current practice, and explores the challenges encountered in attempting to advance the care of patients diagnosed with various stages of HCC, including the co-existence of liver cirrhosis, varying aetiological factors, and the wide clinical and molecular genetic heterogeneity of the disease. Areas of clinical uncertainty in regard to best practice are highlighted together with suggestions for addressing these problems.
| Original language | English |
|---|---|
| Journal | Current Medicinal Chemistry |
| Publication status | Accepted/In press - 6 Nov 2018 |
Keywords
- Hepatocellular carcinoma (HCC)
- scoring systems
- transarterial chemo-embolisation
- targeted agents
- translational research
- genome profiling
