2. Academic Validation
  3. Hepatocellular carcinoma

Hepatocellular carcinoma

  • Nat Rev Dis Primers. 2021 Jan 21;7(1):6. doi: 10.1038/s41572-020-00240-3.
Josep M Llovet 1 2 3,  Robin Kate Kelley 4,  Augusto Villanueva 5,  Amit G Singal 6,  Eli Pikarsky 7,  Sasan Roayaie 8,  Riccardo Lencioni 9 10,  Kazuhiko Koike 11,  Jessica Zucman-Rossi 12 13,  Richard S Finn 14
Affiliations

Affiliations

  • 1 Mount Sinai Liver Cancer Program, Division of Liver Diseases, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. josep.llovet@mssm.edu.
  • 2 Translational Research in Hepatic Oncology, Liver Unit, IDIBAPS, Hospital Clinic, University of Barcelona, Catalonia, Spain. josep.llovet@mssm.edu.
  • 3 Institució Catalana d'Estudis Avançats (ICREA), Barcelona, Catalonia, Spain. josep.llovet@mssm.edu.
  • 4 Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco, CA, USA.
  • 5 Mount Sinai Liver Cancer Program, Division of Liver Diseases, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 6 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • 7 The Lautenberg Center for Immunology and Cancer Research, IMRIC, The Hebrew University of Jerusalem, Jerusalem, Israel.
  • 8 White Plains Hospital Center for Cancer Care, Montefiore Health, White Plains, NY, USA.
  • 9 Department of Radiology, Pisa University School of Medicine, Pisa, Italy.
  • 10 Department of Radiology, Miami Cancer Insitute, Miami, FL, USA.
  • 11 The University of Tokyo, Department of Gastroenterology, Tokyo, Japan.
  • 12 Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, USPC, Université Paris Descartes, Université Paris Diderot, Paris, France.
  • 13 Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • 14 Department of Oncology, Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
PMID: 33479224 DOI: 10.1038/s41572-020-00240-3
Abstract

Liver Cancer remains a global health challenge, with an estimated incidence of >1 million cases by 2025. Hepatocellular carcinoma (HCC) is the most common form of liver Cancer and accounts for ~90% of cases. Infection by hepatitis B virus and hepatitis C virus are the main risk factors for HCC development, although non-alcoholic steatohepatitis associated with metabolic syndrome or diabetes mellitus is becoming a more frequent risk factor in the West. Moreover, non-alcoholic steatohepatitis-associated HCC has a unique molecular pathogenesis. Approximately 25% of all HCCs present with potentially actionable mutations, which are yet to be translated into the clinical practice. Diagnosis based upon non-invasive criteria is currently challenged by the need for molecular information that requires tissue or liquid biopsies. The current major advancements have impacted the management of patients with advanced HCC. Six systemic therapies have been approved based on phase III trials (atezolizumab plus bevacizumab, sorafenib, lenvatinib, regorafenib, cabozantinib and ramucirumab) and three additional therapies have obtained accelerated FDA approval owing to evidence of efficacy. New trials are exploring combination therapies, including checkpoint inhibitors and tyrosine kinase inhibitors or anti-VEGF therapies, or even combinations of two immunotherapy regimens. The outcomes of these trials are expected to change the landscape of HCC management at all evolutionary stages.

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