Hepatocellular carcinoma (HCC) is a type of liver cancer that often develops in individuals with chronic liver disease. Treatment options for HCC depend on the stage of the cancer, the patient’s overall health, and other factors. The primary goal of treatment is to remove or destroy the cancer cells while preserving as much healthy liver tissue as possible. Surgery, liver transplant, and ablation therapies such as radiofrequency and microwave ablation are some of the common treatment options for early-stage HCC.
For advanced-stage HCC, systemic therapies such as chemotherapy, targeted therapy, and immunotherapy are often used. Sorafenib and lenvatinib are targeted therapy drugs that have been shown to improve survival in patients with advanced HCC. Immunotherapy drugs such as atezolizumab, bevacizumab, and durvalumab have also been approved for the treatment of advanced HCC.
In the first line of therapy, atezolizumab/bevacizumab, durvalumab/tremelimumab, durvalumab, sorafenib, and lenvatinib are commonly used. In the second line of therapy, cabozantinib, regorafenib, ramucizumab, pembrolizumab, and ipilimumab/nivolumab are commonly used. Cabozantinib is also used as a subsequent line of therapy. Other drugs that may be used in subsequent lines of therapy include regorafenib, ramucizumab, pembrolizumab, and ipilimumab/nivolumab if these are not used previously. The choice of therapy depends on the patient’s individual circumstances, and treatment may be tailored to their specific needs.
| First-line | Second-line |
|---|---|
| Atezolizumab/Bevacizumab (Tecentriq/Avastin) | Cabozantinib (Cabometyx) |
| Durvalumab/Tremelimumab (Imfinzi/Tremfya) | Regorafenib (Stivarga) |
| Durvalumab (Imfinzi) | Ramucirumab (Cyramza) |
| Sorafenib (Nexavar) | Pembrolizumab (Keytruda) |
| Lenvatinib (Lenvima) | Ipilimumab/Nivolumab (Yervoy/Opdivo) |
It is important to have a discussion with your doctor about the best treatment options for your specific case of hepatocellular carcinoma. Your doctor will consider factors such as the stage of the cancer, the location and size of the tumor, and your overall health and medical history. During your discussion, you can ask your doctor about the benefits and potential side effects of each treatment option. You may also want to ask about the success rates of each treatment, how long the treatment will last, and how it may impact your quality of life. Your doctor may also recommend additional tests or procedures to further evaluate the cancer and determine the best course of treatment.
