Challenges in liver cancer and possible treatment approaches

Abstract

Globally, liver cancer is the most frequent fatal malignancy; in the United States, it ranks fifth. Patients are often diagnosed with liver cancer in advanced stages, contributing to its poor prognosis. Of all liver cancer cases, >90% are hepatocellular carcinomas (HCCs) for which chemotherapy and immunotherapy are the best options for therapy. For liver cancer patients, new treatment options are necessary. Use of natural compounds and/or nanotechnology may provide patients with better outcomes with lower systemic toxicity and fewer side effects. Improved treatments can lead to better prognoses. Finally, in this review, we present some of the problems and current treatment options contributing to the poor outcomes for patients with liver cancer.

Keywords: Chemotherapeutics; Immunotherapy; Liver cancer; Natural compound.

Fig. 1:. Schematic demonstrating HCC cells inducing T-cells;

inactivating T-cells, leaving B-cells unstimulated necessary for class switching. T-cells are activated to induce the immune response via IFN-gamma, IL-2, cytokine release, and stimulating B-cells to undergo class switching.

Fig. 2.. Schematic of nanoparticle therapy on HCC cells.

Top-middle, ODDCSN (organic dye-doped core-shell nanoparticle) releasing contents while bound to antibody, inducing apoptosis. Bottom-left, MTL-CEBPA binds to the CEBPA gene, increasing transcription and leading to an increase in tumor suppressor proteins causing decreased cell proliferation and metastasis. Top-right, NBTXR3 activated by SBRT, leading to intracellular release of the drug and inducing cell death. Middle-left, silica nanoparticles with a mesoporous and rattle-type (SNMRT) structures provide center of a hollow mesoporous shell to be loaded with drug and released through pores upon stimuli. Here, the silica nanoparticle is releasing chemotherapeutics inside cell to induce apoptosis.