Update on systemic therapy for hepatocellular carcinoma

Abstract

With the development of molecular-targeted agents, such as sorafenib and lenvatinib, and immunothera-pies, such as atezolizumab＋bevacizumab and durvalumab＋tremelimumab, systemic therapy for hepatocellu-lar carcinoma has become mainstream. Molecular-targeted agents are selected when immunotherapy is not re-quired or is ineffective. Selecting the appropriate treatment strategy needs to consider the patient’s condition, expected treatment response, and adverse events. Perioperative adjuvant therapy after curative treatment for early-stage disease, combined therapy with transarterial chemoembolization for intermediate-stage disease, and newer agents and combined regimens as first-or second-line treatments for advanced-stage disease are currently being developed. Systemic therapy is now available for any disease stage. Previously, local therapy used to be the main treatment strategy for hepatocellular carcinoma; however, systemic therapy is now being actively tried in combination with local therapy. Systemic therapy is currently the main focus of developing novel treatments for hepatocellular carcinoma.