Updates on clinical trials for the management of hepatocellular carcinoma

Aimen Farooq, Zohaib Ahmed, James Wert, Anum Jalil, James Yu, Vadim Zaytsev, Sarfraz Ahmad

Research output: Chapter in Book/Report/Conference proceedingChapter


Hepatocellular carcinoma (HCC) is the most common primary liver cancer. It is the leading cause of death in patients with cirrhosis and the fourth most common cause of cancer-related mortality in the world. In the recent years, we have seen the emergence of promising therapies for the treatment of HCC. Locoregional therapies including surgical resection, liver transplant, Image-guided ablation, and chemoembolization have survival benefits in early disease limited to liver, however each modality has its own limitations. Unfortunately, most of the patients are diagnosed in advance stage of disease requiring systemic management. Sorafenib has been the mainstay of treatment for a decade until the introduction of lenvatinib, which is noninferior to sorafenib. Finally, survival benefit of regorafenib in HCC patients who progress on sorafenib has heralded a new era of second-line treatment, quickly followed by ramucirumab, cabozantinib, and immune checkpoint inhibitors (ICIs). Combination therapies with ICIs and targeted agents in conjunction with locoregional therapies have shown promise paving the way for further clinical trials. Effort is needed to develop additional novel therapies to potentially augment the current standard treatments as well as to understand the underlying drug resistance mechanisms and prognostic parameters in order to improve survival in patients with HCC.

Original languageEnglish (US)
Title of host publicationTheranostics and Precision Medicine for the Management of Hepatocellular Carcinoma
Subtitle of host publicationVolume 3: Translational and Clinical Outcomes
Number of pages15
ISBN (Electronic)9780323992831
ISBN (Print)9780323992848
StatePublished - Jan 1 2022
Externally publishedYes


  • chemoembolization
  • cirrhosis
  • clinical trials
  • hepatitis virus
  • Hepatocellular cancer
  • immunotherapy
  • lenvatinib
  • liver transplant
  • sorafenib

ASJC Scopus subject areas

  • General Computer Science


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