Urquijo-Ponce JJ, Alventosa-Mateu C, Latorre-Sánchez M, Castelló-Miralles I, Diago M. Present and future of new systemic therapies for early and intermediate stages of hepatocellular carcinoma. World J Gastroenterol 2024; 30(19): 2512-2522 [PMID: 38817666 DOI: 10.3748/wjg.v30.i19.2512]
Corresponding Author of This Article
Carlos Alventosa-Mateu, MD, PhD, Doctor, Hepatology Unit, Department of Digestive Diseases, Consorcio Hospital General Universitario of Valencia, Av Tres Cruces 2, Valencia 46014, Spain. almacar84@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 21, 2024; 30(19): 2512-2522 Published online May 21, 2024. doi: 10.3748/wjg.v30.i19.2512
Present and future of new systemic therapies for early and intermediate stages of hepatocellular carcinoma
Juan Jose Urquijo-Ponce, Carlos Alventosa-Mateu, Mercedes Latorre-Sánchez, Inmaculada Castelló-Miralles, Moisés Diago
Juan Jose Urquijo-Ponce, Carlos Alventosa-Mateu, Mercedes Latorre-Sánchez, Inmaculada Castelló-Miralles, Moisés Diago, Hepatology Unit, Department of Digestive Diseases, Consorcio Hospital General Universitario of Valencia, Valencia 46014, Spain
Author contributions: Urquijo-Ponce JJ and Alventosa-Mateu C have equally contributed to the preparation of the manuscript; Urquijo-Ponce JJ designed the review, collected and analyzed the data and wrote the manuscript; Alventosa-Mateu C designed the review, collected and analyzed the data, elaborated the figures and tables and wrote the manuscript; Latorre-Sánchez M, Castelló-Miralles I and Diago M reviewed and revised the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: Juan Jose Urquijo-Ponce and Moisés Diago have been paid for serving as a speaker and consultant for Roche. The remaining authors disclose no conflicts of interest to declare regarding the topics covered in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Carlos Alventosa-Mateu, MD, PhD, Doctor, Hepatology Unit, Department of Digestive Diseases, Consorcio Hospital General Universitario of Valencia, Av Tres Cruces 2, Valencia 46014, Spain. almacar84@hotmail.com
Received: February 22, 2024 Revised: April 8, 2024 Accepted: April 26, 2024 Published online: May 21, 2024 Processing time: 87 Days and 12.3 Hours
Abstract
Hepatocellular carcinoma (HCC) is a high mortality neoplasm which usually appears on a cirrhotic liver. The therapeutic arsenal and subsequent prognostic outlook are intrinsically linked to the HCC stage at diagnosis. Notwithstanding the current deployment of treatments with curative intent (liver resection/local ablation and liver transplantation) in early and intermediate stages, a high rate of HCC recurrence persists, underscoring a pivotal clinical challenge. Emergent systemic therapies (ST), particularly immunotherapy, have demonstrate promising outcomes in terms of increase overall survival, but they are currently bound to the advanced stage of HCC. This review provides a comprehensive analysis of the literature, encompassing studies up to March 10, 2024, evaluating the impact of novel ST in the early and intermediate HCC stages, specially focusing on the findings of neoadjuvant and adjuvant regimens, aimed at increasing significantly overall survival and recurrence-free survival after a treatment with curative intent. We also investigate the potential role of ST in enhancing the downstaging rate for the intermediate-stage HCC initially deemed ineligible for treatment with curative intent. Finally, we critically discuss about the current relevance of the results of these studies and the encouraging future implications of ST in the treatment schedules of early and intermediate HCC stages.
Core Tip: This review provides an updated analysis (up to March 2024) of the current data about the new systemic therapies for the hepatocellular carcinoma (HCC) in the early and intermediate stages; specially focusing on the findings of neoadjuvant and adjuvant systemic therapies after a treatment with curative intent, for prevention of HCC recurrence. Finally, we discuss about the potential benefits of these new systemic therapies for early and intermediate stages of HCC and their future impact in the HCC treatment schedules.
