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Review|Volume 12, Issue 3|pp 3053—3094

New landscapes and horizons in hepatocellular carcinoma therapy

Melchiorre Cervello1, Maria R. Emma1, Giuseppa Augello1, Antonella Cusimano1, Lydia Giannitrapani1,2, Maurizio Soresi2, Shaw M. Akula3, Stephen L. Abrams3, Linda S. Steelman3, Alessandro Gulino4, Beatrice Belmonte4, Giuseppe Montalto1,2, James A. McCubrey3
  • 1Institute for Biomedical Research and Innovation, National Research Council (CNR), Palermo, Italy
  • 2Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
  • 3Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University, Greenville, NC 27858, USA
  • 4Tumour Immunology Unit, Human Pathology Section, Department of Health Science, University of Palermo, Palermo, Italy
Received: December 11, 2019Accepted: January 12, 2020Published: February 4, 2020
https://doi.org/10.18632/aging.102777

Copyright: © 2020 Cervello et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Hepatocellular carcinoma (HCC), is the sixth most frequent form of cancer and leads to the fourth highest number of deaths each year. HCC results from a combination of environmental factors and aging as there are driver mutations at oncogenes which occur during aging. Most of HCCs are diagnosed at advanced stage preventing curative therapies. Treatment in advanced stage is a challenging and pressing problem, and novel and well-tolerated therapies are urgently needed. We will discuss further advances beyond sorafenib that target additional signaling pathways and immune checkpoint proteins. The scenario of possible systemic therapies for patients with advanced HCC has changed dramatically in recent years. Personalized genomics and various other omics approaches may identify actionable biochemical targets, which are activated in individual patients, which may enhance therapeutic outcomes. Further studies are needed to identify predictive biomarkers and aberrantly activated signaling pathways capable of guiding the clinician in choosing the most appropriate therapy for the individual patient.