Hepatocellular Carcinoma Management and Treatment Strategies

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and ranks among the leading causes of cancer‐related mortality worldwide. Management hinges on early detection through surveillance programmes in high-risk populations, accurate staging and tailoring therapeutic options to disease extent and liver function. Curative interventions include surgical resection, liver transplantation and percutaneous ablation for small tumours in patients with preserved hepatic reserve. For intermediate‐stage disease, locoregional approaches such as transarterial chemoembolization offer disease control by delivering cytotoxic agents directly to the tumour vasculature. Advanced HCC has long been refractory to conventional chemotherapy, but targeted agents and immunotherapies have extended survival. First-line systemic therapies now include multikinase inhibitors and combinations of immune checkpoint inhibitors with anti-angiogenic antibodies. Recent emphasis has fallen on refining patient stratification through molecular and radiomic biomarkers, optimising combination regimens to overcome resistance and exploring novel modalities such as gene delivery systems, oncolytic vectors and cellular immunotherapy. These advances reflect a shift towards personalised, multimodal strategies that integrate tumour biology, host immunity and real-time assessment of treatment response.

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Hepatocellular Carcinoma Management and Treatment Strategies publication trend

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

Technical terms

Hepatocellular carcinoma (HCC): The predominant form of primary liver cancer arising from hepatocytes, often linked to chronic liver disease and cirrhosis.

Transarterial chemoembolization (TACE): A locoregional therapy delivering chemotherapy mixed with embolic agents into the hepatic artery, inducing ischaemia and tumour necrosis.

Immune checkpoint inhibitor (ICI): An antibody-based therapy that blocks inhibitory pathways such as PD-1/PD-L1 or CTLA-4 to enhance T-cell-mediated anti-tumour immunity.

Tyrosine kinase inhibitor (TKI): A small-molecule drug that inhibits signalling enzymes involved in tumour proliferation and angiogenesis, for example sorafenib and lenvatinib.

Radiofrequency ablation (RFA): A technique using thermal energy delivered via a probe to destroy tumour tissue in situ, typically reserved for small HCC nodules.

Child–Pugh score: A clinical classification assessing severity of chronic liver disease based on bilirubin, albumin, ascites, encephalopathy and prothrombin time.

References

1. Lenvatinib as an Initial Treatment in Patients with Intermediate-Stage Hepatocellular Carcinoma Beyond Up-To-Seven Criteria and Child–Pugh A Liver Function: A Proof-Of-Concept Study. Cancers (2019).
2. Tumor Immune Microenvironment and Immunosuppressive Therapy in Hepatocellular Carcinoma: A Review. International Journal of Molecular Sciences (2021).
3. Emerging Therapies for Hepatocellular Carcinoma (HCC). Cancers (2022).