Abstract
Background Hepatocellular carcinoma is one of the most common and lethal malignant tumors worldwide. Over the past 15 years, the incidence of HCC has more than doubled. Due to late diagnosis and/or advanced underlying liver cirrhosis, only limited treatment options with marginal clinical benefit are available in up to 70% of patients. During the last decades, no effective conventional cytotoxic systemic therapy was available contributing to the dismal prognosis in patients with HCC. A better knowledge of molecular hepatocarcinogenesis provides today the opportunity for targeted therapy. Materials and Methods A search of the literature was made using cancer literature, the PubMed, Scopus, and Web of Science (WOS) database for the following keywords: “hepatocellular carcinoma,” “molecular hepatocarcinogenesis,” “targeted therapy,” and “immunotherapy.” Discussion and Conclusion. Treatment decisions are complex and dependent upon tumor staging, presence of portal hypertension, and the underlying degree of liver dysfunction. The knowledge of molecular hepatocarcinogenesis broadened the horizon for patients with advanced HCC. During the last years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. In the future, new therapeutic options will be represented by a blend of immunotherapy-like vaccines and T-cell modulators, supplemented by molecularly targeted inhibitors of tumor signaling pathways.
Highlights
Hepatocellular carcinoma is one of the most common and lethal malignant tumors worldwide
(MAPK) signaling pathway or with p53, an oxidative stress- expressed in hepatocellular carcinoma (HCC) [39] and VEGF levels correlate with mediated mechanism is involved, as it is established in angiogenic activity, tumor progression, and poor prognosis alcohol-induced hepatocarcinogenesis [33, 34]
Several pathways are implicated in hepatocarcinogenesis, and agents that target these pathways continue to be developed and effective drugs can be synthesized and used to
Summary
Hepatocellular carcinoma is one of the most common and lethal malignant tumors worldwide. Due to late diagnosis and/or advanced underlying liver cirrhosis, only limited treatment options with marginal clinical benefit are available in up to 70% of patients. Over the past 15 years, the incidence of hepatocellular and diabetes, which can promote the development of liver carcinoma (HCC) has more than doubled. No systemic therapy could be considered a standard of care for patients with advanced HCC in the preera of targeted therapy [25]. Agents such as octreotide, tamoxifen, and antiandrogens are ineffective. New therapeutic options will be represented by a blend of immunotherapy-like vaccines and T-cell modulators, supplemented by molecularly targeted inhibitors of tumor signaling pathways. The knowledge of the mechanisms of hepatocarcinogenesis in HCC is crucial
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