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Review
. 2024 Mar 30;14(4):370.
doi: 10.3390/jpm14040370.

MASLD-Related HCC-Update on Pathogenesis and Current Treatment Options

Catherine Leyh  1 , Jason D Coombes  2 , Hartmut H Schmidt  3 , Ali Canbay  4 , Paul P Manka  4 , Jan Best  3
Affiliations
Review

MASLD-Related HCC-Update on Pathogenesis and Current Treatment Options

Catherine Leyh et al. J Pers Med. .

Abstract

Hepatocellular carcinoma (HCC) is a common complication of chronic liver diseases and remains a relevant cause of cancer-related mortality worldwide. The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) as a risk factor for hepatocarcinogenesis is on the rise. Early detection of HCC has been crucial in improving the survival outcomes of patients with metabolic dysfunction-associated steatohepatitis (MASH), even in the absence of cirrhosis. Understanding how hepatocarcinogenesis develops in MASH is increasingly becoming a current research focus. Additive risk factors such as type 2 diabetes mellitus (T2DM), genetic polymorphisms, and intestinal microbiota may have specific impacts. Pathophysiological and epidemiological associations between MASH and HCC will be discussed in this review. We will additionally review the available tumor therapies concerning their efficacy in MASH-associated HCC treatment.

Keywords: HCC; MASH; MASLD; NAFLD; NASH; biomarker; hepatocellular carcinoma; intestinal microbiota.

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Conflict of interest statement

C.L. and J.D.C. certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. P.P.M. reports personal fees and non-financial support from Intercept Pharmaceuticals. J.B. reports personal fees and non-financial support from Roche, BMS, Novartis, EISAI, Falk, Ipsen, MSD, Boston Scientific. No other potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Diagnostic criteria and risk factors for MASLD and progression of MASLD to MASH-HCC [19]. In the progression from MASLD to MASH, MASH fibrosis, and finally cirrhosis, a variety of factors (type 2 diabetes mellitus, obesity, microbiome, genetic and epigenetic factors, lifestyle) have a similar effect on hepatocarcinogenesis. HCC risk appears to correlate with the extent of fibrosis, but MASH-associated HCC may develop even without cirrhosis. The time to which the above factors, particularly type 2 diabetes, have direct carcinogenic potential has not been conclusively determined. Abbreviations: MetALD: metabolic dysfunction and alcohol-associated steatotic liver disease, BMI: body mass index; WC: waist circumference.
See this image and copyright information in PMC

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