Hepatocellular Carcinoma (HCC) is the most common type of primary liver cancer, accounting for 85% of total liver cancer cases.

HCC is one of the leading causes of cancer-related mortality worldwide and has a poor prognosis due to the lack of effective treatment options. Over the last few decades, there have been significant advancements in HCC research, including better understanding of the disease pathology, advanced diagnostic methods, groundbreaking treatments, and promising drug therapies.

This article will provide an overview of recent research developments related to HCC.

Understanding HCC

One of the recent advancements in HCC research is the identification of biomarkers that can help diagnose and predict the outcome of HCC.

Several studies have identified a combination of biomarkers, including alpha-fetoprotein (AFP), glypican-3 (GPC-3), and des-gamma-carboxy prothrombin (DCP), that can be used for HCC diagnosis and surveillance. The use of these biomarkers can improve the detection of early-stage HCC and guide treatment decisions.

Diagnostic Methods

Advancement in imaging techniques has significantly improved the detection and diagnosis of HCC. Ultrasonography is the most commonly used imaging technique for HCC diagnosis, as it is non-invasive and cost-effective.

However, it has a limited sensitivity in detecting small tumors. Magnetic resonance imaging (MRI) and computed tomography (CT) scans are more accurate in detecting small tumors but are more expensive and time-consuming.

Recently, the use of contrast-enhanced ultrasound (CEUS) has shown promising results in detecting small HCCs with high accuracy.

Surgical Treatment Options

Curative resection and liver transplantation are the most effective treatments for early-stage HCC.

Advances in liver resection techniques, such as anatomical resection and laparoscopic resection, have led to improved surgical outcomes and reduced morbidity. Liver transplantation is a definitive treatment option for small HCCs that are not suitable for surgical resection.

Recently, living donor liver transplantation (LDLT) has emerged as a preferred option for liver transplantation, especially in regions with a shortage of deceased donor organs.

Non-Surgical Treatment Options

HCCs that are not amenable to curative resection or liver transplantation usually require non-surgical treatment options.

Transarterial chemoembolization (TACE) is a well-established treatment for intermediate-stage HCC, where the tumor is confined to the liver and has not metastasized. TACE involves injecting chemotherapeutic drugs into the tumor-feeding arteries and blocking them, leading to tumor necrosis.

Recently, new techniques, such as drug-eluting bead TACE (DEB-TACE), have shown better efficacy and safety outcomes compared to conventional TACE.

Immunotherapy

Immunotherapy is a promising treatment option in cancer treatment, including HCC. Immune checkpoint inhibitors (ICIs) have shown remarkable results in the treatment of advanced HCC, where conventional treatments have failed.

ICIs block the immune checkpoints that suppress the immune system’s response to cancer cells, allowing the immune system to attack and destroy cancer cells. Recently, the combination of ICIs with other treatments, such as TACE and molecular-targeted therapies, has shown improved outcomes in advanced HCC.

Molecular-Targeted Therapy

Molecular-targeted therapy involves targeting specific molecules or signaling pathways that drive cancer growth and survival. Sorafenib and lenvatinib are two molecular-targeted therapies that have been approved for the treatment of advanced HCC.

Recently, several new molecular-targeted therapies, such as regorafenib, cabozantinib, and ramucirumab, have shown promising results as second-line therapies in HCC patients who have failed sorafenib treatment.

Prognosis

Prognosis and predicting outcomes are essential in HCC management. The Barcelona Clinic Liver Cancer (BCLC) staging system is widely used to determine the prognosis and treatment strategy of HCC.

Recently, several new prognostic models, such as the albumin-bilirubin (ALBI) score and the liver cancer-specific mortality risk score (LCSMRS), have been developed to improve the accuracy of predicting outcomes and guiding treatment decisions.

Conclusion

Advancements in HCC research have revolutionized the diagnosis, treatment, and management of the disease.

Improved biomarkers, imaging techniques, surgical techniques, and novel treatment options, such as immunotherapy and molecular-targeted therapy, have significantly improved the prognosis of HCC patients. However, HCC remains a challenging disease, with high recurrence rates and therapy resistance in advanced stages.