Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and is often diagnosed at an advanced stage when surgical options are limited. In recent years, non-surgical treatments have emerged as crucial tools in managing advanced hepatocellular carcinoma, offering hope to patients who are not candidates for surgery. Understanding these non-surgical treatment breakthroughs is essential for navigating the complexities of this aggressive cancer.
What is Hepatocellular Carcinoma?
Hepatocellular carcinoma typically arises in the context of chronic liver disease, such as cirrhosis or chronic hepatitis B or C infection. The liver’s role in filtering toxins and processing nutrients makes it particularly vulnerable to cancerous changes when damaged. HCC is a challenging cancer to treat due to its late presentation, often when the liver is already compromised and the cancer has spread beyond the liver.
What is the prognosis for HCC?
When HCC is detected early, surgical resection or liver transplantation can offer a cure. However, the majority of cases are diagnosed at a stage where surgery is no longer viable due to the extent of the disease or poor liver function. This makes non-surgical treatments critical for extending survival and improving the quality of life for these patients.
Breakthroughs in Non-Surgical Treatments
- Targeted Therapies Targeted therapies have revolutionised the treatment of advanced hepatocellular carcinoma (HCC). Nexavar 200mg Tablet containing Sorafenib was the first targeted therapy approved for HCC. It works by inhibiting multiple tyrosine kinases involved in tumour growth and angiogenesis (the formation of new blood vessels that feed the tumour).Â
More recently, other targeted therapies like lenvatinib and regorafenib have been developed, offering additional options for patients who may not respond to Sorafenib. These drugs target similar pathways but with different mechanisms of action, providing an expanded arsenal against HCC.
- Immunotherapy Immunotherapy has emerged as a promising treatment for various cancers, including advanced HCC. Immunotherapy drugs work by enhancing the body’s immune response against cancer cells. The most significant breakthrough in HCC treatment has been the approval of immune checkpoint inhibitors, such as nivolumab and pembrolizumab.
- Radiation Therapy Radiation therapy has traditionally been used sparingly in HCC due to the liver’s sensitivity to radiation. Techniques such as stereotactic body radiation therapy (SBRT) allow for high-dose radiation to be delivered over a few sessions, providing an effective treatment option for patients with inoperable tumours.
- Radioembolisation, also known as selective internal radiation therapy (SIRT), is a minimally invasive procedure that delivers radiation directly to the liver tumour via the hepatic artery. Tiny beads loaded with radioactive material are injected into the artery, where they lodge in the blood vessels supplying the tumour.
- Transarterial Chemoembolization (TACE) TACE is a procedure that delivers chemotherapy directly to the liver tumour via the hepatic artery, combined with embolisation to block the tumour’s blood supply.Â
What is the new treatment for HCC?
One of the most exciting developments in the treatment of advanced hepatocellular carcinoma is the move towards personalised medicine. As our understanding of the molecular biology of HCC grows, so too does our ability to tailor treatments to the specific characteristics of each patient’s tumour.
Genetic and molecular profiling of tumours can identify specific mutations or pathways that can be targeted with precision therapies. This personalised approach increases the likelihood of treatment success and minimises unnecessary side effects.
Quality of Life Considerations
While extending survival is the primary goal of treating advanced hepatocellular carcinoma, quality of life remains a critical concern. Non-surgical treatments often come with side effects that can impact daily living, so managing these side effects is an integral part of the treatment plan.
Supportive care measures, such as managing pain, nutritional support, and addressing psychological needs, are essential components of a comprehensive treatment strategy for HCC. Additionally, regular monitoring of liver function and adjusting treatment as needed are crucial for minimising complications and maintaining the best possible quality of life.
