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Review
. 2021 Jan 21;7(1):6.
doi: 10.1038/s41572-020-00240-3.

Hepatocellular carcinoma

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
Review

Hepatocellular carcinoma

Josep M Llovet et al. Nat Rev Dis Primers. .

Erratum in

  • Author Correction: Hepatocellular carcinoma.
    Llovet JM, Kelley RK, Villanueva A, Singal AG, Pikarsky E, Roayaie S, Lencioni R, Koike K, Zucman-Rossi J, Finn RS. Llovet JM, et al. Nat Rev Dis Primers. 2024 Feb 12;10(1):10. doi: 10.1038/s41572-024-00500-6. Nat Rev Dis Primers. 2024. PMID: 38346997 No abstract available.

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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