Systemic therapy of hepatocellular carcinoma: current status and future perspectives

World J Gastroenterol. 2014 Mar 28;20(12):3087-99. doi: 10.3748/wjg.v20.i12.3087.


The management of hepatocellular carcinoma (HCC) has substantially changed in the past few decades, the introduction of novel therapies (such as sorafenib) have improved patient survival. Nevertheless, HCC remains the third most common cause of cancer-related deaths worldwide. Decision-making largely relies on evidence-based criteria, as showed in the US and European clinical practice guidelines, which endorse five therapeutic recommendations:resection; transplantation; radiofrequency ablation; chemoembolization; and sorafenib. Many molecularly targeted agents that inhibit angiogenesis, epidermal growth factor receptor, and mammalian target of rapamycin are at different stages of clinical development in advanced HCC. Future research should continue to unravel the mechanism of hepatocarcinogenesis and to identify key relevant molecular targets for therapeutic intervention. Identification and validation of potential surrogate and predictive biomarkers hold promise to individualize patient's treatment to maximize clinical benefit and minimize the toxicity and cost of targeted agents.

Keywords: Hepatocellular Carcinoma; Molecular agents; Sorafenib; Targheted therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Animals
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Hepatocellular / therapy*
  • Clinical Trials as Topic
  • ErbB Receptors / antagonists & inhibitors
  • Evidence-Based Medicine
  • Glypicans / antagonists & inhibitors
  • Hormones / therapeutic use
  • Humans
  • Liver Neoplasms / therapy*
  • MAP Kinase Kinase Kinases / antagonists & inhibitors
  • Medical Oncology / trends
  • Molecular Targeted Therapy / methods
  • Niacinamide / analogs & derivatives
  • Niacinamide / therapeutic use
  • Phenylurea Compounds / therapeutic use
  • Protein Kinase Inhibitors / chemistry
  • Sorafenib
  • TOR Serine-Threonine Kinases / metabolism
  • Treatment Outcome


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • GPC3 protein, human
  • Glypicans
  • Hormones
  • Phenylurea Compounds
  • Protein Kinase Inhibitors
  • Niacinamide
  • Sorafenib
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • ErbB Receptors
  • MAP Kinase Kinase Kinases