Advances in the treatment of hepatocellular carcinoma: An overview of the current and evolving therapeutic landscape for clinicians
Abstract
Abstract Hepatocellular carcinoma (HCC) is the sixth most common malignancy and the third leading cause of cancer‐related death worldwide. Contemporary advances in systemic and locoregional therapies have led to changes in peer‐reviewed guidelines regarding systemic therapy as well as the possibility of downstaging disease that may enable some patients with advanced disease to ultimately undergo partial hepatectomy or transplantation with curative intent. This review focuses on all modalities of therapy for HCC, guided by modern‐day practice‐changing randomized data where available. The surgical management of HCC, including resection and transplantation, both of which have evolving criteria for what is considered biologically resectable and transplantable, as well as locoregional therapy (i.e., therapeutic embolization, ablation, radiation, and hepatic arterial infusion), are discussed. Historical and modern‐day practice‐changing trials evaluating immunotherapy with targeted therapies for advanced disease, as well as adjuvant systemic therapy, are also summarized. In addition, this article examines the critical dimension of toxicities and patient‐oriented considerations to ensure a comprehensive and balanced discourse on treatment implications.
Article Details
Authors (13)
Dimitrios Moris
Division of Surgical Oncology Department of Surgery Duke University Medical Center Durham North Carolina USA
Alessandro Martinino
Division of Abdominal Transplantation Department of Surgery Duke University Medical Center Durham North Carolina USA
Sarah Schiltz
Patient Advocate Steering Committee National Cancer Institute Hepatobiliary Task Force Los Gatos California USA
Peter J. Allen
Division of Surgical Oncology Department of Surgery Duke University Medical Center Durham North Carolina USA
Andrew Barbas
Division of Abdominal Transplantation Department of Surgery Duke University Medical Center Durham North Carolina USA
Debra Sudan
Division of Abdominal Transplantation Department of Surgery Duke University Medical Center Durham North Carolina USA
Lindsay King
Division of Gastroenterology and Hepatology Department of Medicine Duke University Medical Center Durham North Carolina USA
Carl Berg
Division of Gastroenterology and Hepatology Department of Medicine Duke University Medical Center Durham North Carolina USA
Charles Kim
Department of Radiology Duke University Medical Center Durham North Carolina USA
Mustafa Bashir
Department of Radiology Duke University Medical Center Durham North Carolina USA
Manisha Palta
Department of Radiation Oncology Duke University Medical Center Durham North Carolina USA
Michael A. Morse
Division of Medical Oncology Department of Medicine Duke University Medical Center Durham North Carolina USA
Michael E. Lidsky
Division of Surgical Oncology Department of Surgery Duke University Medical Center Durham North Carolina USA