Pathogenesis to management of hepatocellular carcinoma
Ben L. Da1, Kelly I. Suchman2, Lawrence Lau3, Atoosa Rabiee4, Aiwu Ruth He5, Kirti Shetty6, Herbert Yu7, Linda L. Wong8, Richard L. Amdur9, James M. Crawford10, Sharon S. Fox10, Gregory M. Grimaldi11, Priya K. Shah11, Jonathan Weinstein12, David Bernstein1, Sanjaya K. Satapathy1, Nyasha Chambwe13, Xiyan Xiang14 and Lopa Mishra14
1 Department of Internal Medicine, Division of Hepatology, Sandra Atlas Bass Center for Liver Diseases and Transplantation, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, NY 11030, USA
2 Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, NY 11030, USA
3 Department of Surgery, North Shore University Hospital, Northwell Health, Manhasset, NY 11030, USA
4 Department of Gastroenterology and Hepatology, VA Medical Center, Washington, DC 20422, USA
5 Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
6 Division of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD 21201, USA
7 Department of Epidemiology, University of Hawaii Cancer Center, Honolulu, HI 96813-5516, USA
8 Department of Surgery, University of Hawaii, Honolulu, HI 96813-5516, USA
9 Quantitative Intelligence, The Institutes for Health Systems Science and Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 10022, USA
10 Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
11 Department of Radiology, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, USA
12 Division of Vascular and Interventional Radiology, Department of Radiology, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, USA
13 The Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030, USA
14 The Institute for Bioelectronic Medicine, The Feinstein Institutes for Medical Research and Cold Spring Harbor Laboratory, Department of Medicine, Division of Gastroenterology and Hepatology, Northwell Health, Manhasset, NY 11030, USA
Correspondence:
Lopa Mishra, email:[email protected]
Keywords: pathogenesis; HCC management; genomic heterogeneity; targeted therapy
Received: September 07, 2022 Accepted: November 17, 2022 Published: December 13, 2022
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer whose incidence continues to rise in many parts of the world due to a concomitant rise in many associated risk factors, such as alcohol use and obesity. Although early-stage HCC can be potentially curable through liver resection, liver-directed therapies, or transplantation, patients usually present with intermediate to advanced disease, which continues to be associated with a poor prognosis. This is because HCC is a cancer with significant complexities, including substantial clinical, histopathologic, and genomic heterogeneity. However, the scientific community has made a major effort to better characterize HCC in those aspects via utilizing tissue sampling and histological classification, whole genome sequencing, and developing viable animal models. These efforts ultimately aim to develop clinically relevant biomarkers and discover molecular targets for new therapies. For example, until recently, there was only one approved systemic therapy for advanced or metastatic HCC in the form of sorafenib. Through these efforts, several additional targeted therapies have gained approval in the United States, although much progress remains to be desired. This review will focus on the link between characterizing the pathogenesis of HCC with current and future HCC management.