Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jan 24;12(2):149.
doi: 10.3390/jpm12020149.

Precision Medicine for Hepatocellular Carcinoma: Clinical Perspective

Danijel Galun  1   2 , Dragana Mijac  1   3 , Aleksandar Filipovic  1   4 , Aleksandar Bogdanovic  1   2 , Marko Zivanovic  2 , Dragan Masulovic  1   4
Affiliations
Review

Precision Medicine for Hepatocellular Carcinoma: Clinical Perspective

Danijel Galun et al. J Pers Med. .

Abstract

Hepatocellular carcinoma (HCC) is one of the major malignant diseases worldwide, characterized by growing incidence and high mortality rates despite apparent improvements in surveillance programs, diagnostic and treatment procedures, molecular therapies, and numerous research initiatives. Most HCCs occur in patients with liver cirrhosis, and the competing mortality risks from the tumor and the cirrhosis should be considered. Presently, previously identified risk factors, such as hepatitis virus infection, hepatic inflammation and fibrosis, and metabolic syndrome, may be used as chemoprevention targets. The application of precision medicine for HCC management challenges the one-size-fits-all concept; moreover, patients should no longer be treated entirely according to the histology of their tumor but based on molecular targets specific to their tumor biology. Next-generation sequencing emphasizes HCC molecular heterogeneity and aids our comprehension of possible vulnerabilities that can be exploited. Moreover, genetic sequencing as part of a precision medicine concept may work as a promising tool for postoperative cancer monitoring. The use of genetic and epigenetic markers to identify therapeutic vulnerability could change the diagnosis and treatment of HCC, which so far was based on Barcelona clinic liver cancer (BCLC) staging. In daily clinical practice, the shift from a stage-oriented to a therapeutic-oriented approach is needed to direct the choice of HCC treatment toward the potentially most effective option on an individual basis. The important factor in precision medicine is the promotion of patient management based on the individual approach, knowing that the final decision must be approved by a multidisciplinary expert team.

Keywords: hepatocellular carcinoma; personalized treatment; precision medicine; targeted therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Modified Barcelona clinic liver cancer (BCLC) staging and treatment algorithm. (b) Real-worldwide clinical practice.
Figure 2
Figure 2
Second-line treatment options for advanced hepatocellular carcinoma. HCC—hepatocellular carcinoma. * Only in patients with AFP > 400 ng/mL.
See this image and copyright information in PMC

References

    1. Galle P.R., Forner A., Llovet J.M., Mazzaferro V., Piscaglia F., Raoul J.L., Schirmacher P., Vilgrain V., European Association for the Study of the Liver EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J. Hepatol. 2019;70:817. doi: 10.1016/j.jhep.2018.03.019. - DOI - PubMed
    1. Llovet J.M., Montal R., Sia D., Finn R.S. Molecular therapies and precision medicine for hepatocellular carcinoma. Nat. Rev. Clin. Oncol. 2018;15:599–616. doi: 10.1038/s41571-018-0073-4. - DOI - PMC - PubMed
    1. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018, GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA-Cancer J. Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Mittal S., El-Serag H.B. Epidemiology of hepatocellular carcinoma: Consider the population. J. Clin. Gastroenterol. 2013;47:S2–S6. doi: 10.1097/MCG.0b013e3182872f29. - DOI - PMC - PubMed
    1. Bishayee A. The role of inflammation and liver Cancer. Adv. Exp. Med. Biol. 2014;816:401–435. doi: 10.1007/978-3-0348-0837-8_16. - DOI - PubMed

LinkOut - more resources