New developments in systemic therapy for hepatocellular carcinoma

Authors S.P. Dourakis.


Hepatocellular carcinoma (HCC) accounts for 90% of
all primary liver cancers. ΗCC is the fifth most common
malignancy and the third cause of cancer death globally
(more than 500.000 cases yearly) with most deaths occurring
within one year of diagnosis.1,2 In 90-95% οf cases,
HCC is developed in cirrhotic liver. Liver transplantation
(from cadaveric or living donors), surgical resection, percutaneous
ethanol injection, transcatheter arterial chemoembolizatin
(TACE) and radio-frequency (RF) thermal
ablation microwaves achieve a relatively high response
rate only in carefully selected candidates with small (diameter
< 5 cm) tumors. Hepatic reserve often dictates the
therapeutic options. Systemic therapy is appropriate for
patients with advanced unresectable disease who are unsuitable
for locoregional therapy and carry dismal prognosis.
Nevertheless, up until now, there have been multitudes
of negative systemic therapy trials for advanced
HCC.3 So, in 60-75% οf HCC cases in Europe and the
USA, no therapy short of palliative approaches was given
to patients.4,5,6,7
Current views