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Background <p>Systemic therapy of hepatocellular carcinoma (HCC) plays a&#xa0;role primarily in advanced stages (BCLC&#xa0;C according to the Barcelona Clinic Liver Cancer classification) but may also be indicated in intermediate stages for tumors confined to the liver (BCLC&#xa0;B). A&#xa0;prerequisite remains preserved liver function, and systemic therapy is generally contraindicated in cases of decompensated cirrhosis.</p> Objective <p>Due to the relatively large number of approved treatments, oncologists now have a&#xa0;wide range of options available for systemic therapy of HCC. This article presents the current systemic therapy—from first-line immune combination therapies to tyrosine kinase inhibitors—taking into account efficacy, side effects, and relevant aspects in clinical application.</p> Methods <p>Analysis and iscussion of relevant studies, real-world analyses, and clinical guidelines.</p> Results <p>Immune combination therapies significantly improve overall survival with a&#xa0;manageable risk profile in HCC patients. Tyrosine kinase inhibitors remain a&#xa0;relevant therapeutic option in cases where immunotherapy is contraindicated and in sequential therapy. Currently, adjuvant and neoadjuvant therapeutic concepts have no proven benefit. New concepts combining systemic and locoregional therapies are currently being investigated in clinical trials. Individualized approaches with resection or even transplantation in patients with a&#xa0;good response to systemic therapy are possible in selected cases.</p>

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Systemtherapie beim hepatozellulären Karzinom

  • 期刊论文

  • 发表日期：

    2026年2月17日

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  • Ulrike Bauer,
  • Ursula Ehmer

摘要

Background

Systemic therapy of hepatocellular carcinoma (HCC) plays a role primarily in advanced stages (BCLC C according to the Barcelona Clinic Liver Cancer classification) but may also be indicated in intermediate stages for tumors confined to the liver (BCLC B). A prerequisite remains preserved liver function, and systemic therapy is generally contraindicated in cases of decompensated cirrhosis.

Objective

Due to the relatively large number of approved treatments, oncologists now have a wide range of options available for systemic therapy of HCC. This article presents the current systemic therapy—from first-line immune combination therapies to tyrosine kinase inhibitors—taking into account efficacy, side effects, and relevant aspects in clinical application.

Methods

Analysis and iscussion of relevant studies, real-world analyses, and clinical guidelines.

Results

Immune combination therapies significantly improve overall survival with a manageable risk profile in HCC patients. Tyrosine kinase inhibitors remain a relevant therapeutic option in cases where immunotherapy is contraindicated and in sequential therapy. Currently, adjuvant and neoadjuvant therapeutic concepts have no proven benefit. New concepts combining systemic and locoregional therapies are currently being investigated in clinical trials. Individualized approaches with resection or even transplantation in patients with a good response to systemic therapy are possible in selected cases.