Hepatocellular carcinoma (HCC) – Drug therapy

Liver cell cancer usually develops in a previously damaged liver (liver fibrosis, liver cirrhosis of various causes). The initial diagnosis is often made after several years of medical history. Initially, HCC is usually treated locally through surgery or liver-directed therapies (ablation, SIRT, TACE). Liver transplantation can also be used in selected cases in the early stages. If it is no longer possible to control the disease with local therapies or if metastases are found outside the liver, systemic therapy is used, which has improved considerably in recent years.

Chemotherapy

Chemotherapy is hardly effective in liver cell cancer and is only used in practice for rare mixed tumors of bile duct and liver cell cancer.

Targeted therapies

Molecularly targeted therapies are either antibodies that are administered as an infusion and bind highly specifically to the surface of cancer cells or smaller molecules that are taken in tablet form, penetrate the cancer cells and interrupt metabolic processes. Both principles are used for liver cell cancer. Several tyrosine kinase blockers (e.g. lenvatinib, sorafenib, cabozantinib, regorafenib) are used in systemic HCC therapy in different disease situations. In addition, antibodies against vascular receptors (anti-VEGF(R)) are also used, either alone (ramucirumab) or in combination with immunotherapy (bevacizumab).

Immunotherapy

Cancer immunotherapies used against liver cell cancer activate the body’s own immune cells (T-cells) in a highly specific manner, enabling them to destroy cancer cells more effectively. In liver cell cancer, anti-PD1/PD-L1 antibodies in particular, but also anti-CTLA4 antibodies are used, typically in combination treatment. Many new substances and combinations are currently being tested in clinical trials, such as those offered at our liver center.