Hepatocellular carcinoma (HCC) is one of the leading causes of cancer
related deaths worldwide, especially in Asia. Late diagnosis and/or underlying
cirrhosis, and limited treatment options with marginal clinical benefit are the reasons
for its dismal prognosis. Surgical resection and liver transplantation are curative
treatment options but are suitable for patients with small tumours or well-compensated
liver diseases. For patients with non-resectable HCC, treatment options include ablative
and systemic therapies. However, the results are unsatisfactory with limited long-term
survival. In the last few years there has been active research in the area of molecularly
targeted agents for HCC including anti-angiogenic therapy, immunotherapy, antiviral
therapy, and other agents targeting mammalian target of rapamycin (mTOR), and c-met
among others. This chapter will look into current treatment options, discuss their
advantages and disadvantages, as well as introduce new therapies that are under clinical
investigation but not yet recommended by acceptable guidelines. Although there is
tremendous research in progress, the treatment modalities offer limited survival benefit
and thus the battle against HCC is far from over.
Keywords: Anti-angiogenic therapy, Antiviral therapy, Chemotherapy, c-Met
inhibitors, Hepatocellular carcinoma, Immune based therapy, Local ablative
therapy, mTOR inhibitors, Sorafenib, TACE.
