| Popis: |
Over 1 million cases of liver cancer are estimated to occur by 2025, making it a global health challenge. In almost 90% of cases of liver cancer, it is hepatocellular carcinoma (HCC). The main risk factors for HCC development are infection with hepatitis B and C viruses, although nonalcoholic steatohepatitis (NASH) associated with metabolic syndrome or diabetes mellitus is becoming more prevalent in the West. The molecular pathogenesis of nonalcoholic steatohepatitis-associated HCC is unique. A quarter of all HCCs present with mutations that are potentially actionable but have not yet been translated into clinical practice. In the advanced stages of the disease, systemic therapy is expected to be administered 50–60% of the time to HCC patients. In phase III trials, six systemic therapies have been approved (atezolizumab plus bevacizumab, sorafenib, lenvatinib, regorafenib, cabozantinib, and ramucirumab), and new trials are evaluating combination therapies, such as checkpoint inhibitors and tyrosine kinase inhibitors or anti-VEGF therapies. The findings of these clinical trials are expected to alter the landscape of managing HCC at all stages of the disease. |
