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Clinical Options for Treatment of Hepatocellular Carcinoma

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Clinical Applications of Nuclear Medicine Targeted Therapy

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Abstract

Management of HCC depends on tumor stage, liver function, and patient performance status (BCLC stage) and requires a multidisciplinary approach for optimal treatment. Hepatic resection, liver transplantation, and local ablation of HCC up to 3 cm are curative options in the early stage of disease. There have been significant advances in transarterial embolotherapies (TACE and TARE) in intermediate/advanced stages. Drug-eluting beads have improved the efficacy and safety of conventional TACE, and radioembolization has set a new standard of treatment that delivers the radiation effect to tumor location without compromising the surrounding fragile liver tissue. Molecular studies on HCC have identified aberrant activation of several signaling pathways, which may represent key targets for novel molecular therapies. Immunotherapy is emerging as an additional option in properly selected patients.

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Abbreviations

AFP:

Alpha-fetoprotein

BCLC:

Barcelona Clinic Liver Cancer

CT:

Computed tomography

DAA:

Direct-acting antiviral

DEB:

Drug-eluting beads

DFS:

Disease-free survival

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

HDV:

Hepatitis D virus

LA:

Laser ablation

LDLT:

Living donor liver transplantation

LR:

Liver resection

LT:

Liver transplantation

MDCT:

Multiple detector computed tomography

MELD:

Model for end-stage liver disease

MRI:

Magnetic resonance imaging

MW:

Microwave

NAFLD:

Non-alcoholic fatty liver disease

OS:

Overall survival

PEI:

Percutaneous ethanol injection

PS:

Performance status

PVT:

Portal vein thrombosis

RFA:

Radiofrequency ablation

TACE:

Transarterial chemoembolization

TARE:

Transarterial radioembolization

UCSF:

University of California at San Francisco

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Authors and Affiliations

  1. Hepato-Oncology Group, Surgical Oncology, HPB and Liver Transplantation, Istituto Nazionale Tumori (National Cancer Institute) IRCCS Foundation, Milan, Italy

    Matteo Virdis, Michela Monteleone, Michele Droz dit Busset & Vincenzo Mazzaferro

  2. University of Milan, Milan, Italy

    Vincenzo Mazzaferro

Authors
  1. Matteo Virdis
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  2. Michela Monteleone
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  3. Michele Droz dit Busset
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  4. Vincenzo Mazzaferro
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Corresponding author

Correspondence to Vincenzo Mazzaferro .

Editor information

Editors and Affiliations

  1. Department of Nuclear Medicine, Humanitas Gavazzeni Hospital, Bergamo, Italy

    Emilio Bombardieri

  2. Nuclear Medicine Therapy and Endocrinology, Istituto Nazionale dei Tumori, Milano, Italy

    Ettore Seregni

  3. Nuclear Medicine and Molecular Imaging Unit, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy

    Laura Evangelista

  4. Nuclear Medicine Division, Istituto Nazionale dei Tumori, Milano, Italy

    Carlo Chiesa

  5. Nuclear Medicine, Humanitas Research Hospital, Rozzano, Milano, Italy

    Arturo Chiti

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Virdis, M., Monteleone, M., Busset, M.D.d., Mazzaferro, V. (2018). Clinical Options for Treatment of Hepatocellular Carcinoma. In: Bombardieri, E., Seregni, E., Evangelista, L., Chiesa, C., Chiti, A. (eds) Clinical Applications of Nuclear Medicine Targeted Therapy . Springer, Cham. https://doi.org/10.1007/978-3-319-63067-0_9

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  • DOI: https://doi.org/10.1007/978-3-319-63067-0_9

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