Adjuvant Therapies in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, with long-term survival limited by high rates of postoperative recurrence. Adjuvant therapies, delivered after curative-intent resection or ablation, aim to eradicate residual microscopic disease, delay relapse and improve overall outcomes. Approaches focus on locoregional interventions such as transarterial chemoembolization (TACE) and radiotherapy, alongside systemic modalities encompassing small-molecule targeted agents and immunotherapies. While TACE exploits hepatic arterial delivery of cytotoxics and embolic agents to starve micrometastases, advances in radiotherapy have refined dose delivery to enhance efficacy against microvascular invasion. On a systemic level, tyrosine kinase inhibitors (TKIs) attenuate signalling pathways involved in angiogenesis and proliferation, and immune checkpoint inhibitors reinvigorate antitumour immunity. Patient stratification according to risk factors—such as tumour size, microvascular invasion and molecular biomarkers—has emerged as pivotal for tailoring adjuvant regimens. Efforts to integrate predictive tools and molecular profiling promise more personalised decision-making. Despite promising signals, challenges persist in identifying patients most likely to benefit, managing therapy-related toxicity and conducting high-quality multinational trials. Effective adjuvant strategies have the potential to reduce recurrence, extend survival and optimise quality of life for HCC patients across diverse healthcare settings.

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Adjuvant Therapies in Hepatocellular Carcinoma publication trend

The graph below shows the total number of articles in adjuvant therapies in hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).

Technical terms

Adjuvant therapy: Treatment given after primary surgery or ablation to reduce the risk of tumour recurrence.

Transarterial chemoembolization (TACE): Locoregional procedure delivering chemotherapy and embolic agents via the hepatic artery to target residual cancer cells.

Tyrosine kinase inhibitor (TKI): Small-molecule drug blocking signalling pathways essential for tumour growth and angiogenesis.

Immune checkpoint inhibitor (anti-PD-1 antibody): Agent that restores T-cell activity by blocking programmed cell death protein 1, enhancing antitumour immunity.

Recurrence-free survival (RFS): Length of time after treatment during which the patient remains free of detectable cancer relapse.

References

1. Down-regulation of ALDOB during metabolic reprogramming mediates malignant behavior in hepatocellular carcinoma and insensitivity to postoperative adjuvant transarterial chemoembolization. Clinical Science (2023).
2. Postoperative adjuvant tyrosine kinase inhibitors combined with anti-PD-1 antibodies improves surgical outcomes for hepatocellular carcinoma with high-risk recurrent factors. Frontiers in Immunology (2023).
3. The Current and Prospective Adjuvant Therapies for Hepatocellular Carcinoma. Cancers (2024).
4. Postoperative adjuvant radiotherapy is associated with improved survival in hepatocellular carcinoma with microvascular invasion. Oncotarget (2017).