The Future of Treating One of the Deadliest Forms of Cancer

What is Hepatocellular Carcinoma, and why is it significant?

Hepatocellular carcinoma (HCC) refers to a form of liver cancer, often associated with fatty liver disease, hepatitis B, and hepatitis C. HCC has established itself as a leading cause of cancer-related deaths worldwide, with 90% of all worldwide liver cancer is considered HCC (Alawyia & Constantinou, 2023).

Alongside its prevalence, it poses several significant challenges that make it difficult to develop a standardized treatment. Current curative measures such as surgical removal, transplantation, or ablation are commonly used, but their success rate is limited. Some studies suggesting a 5-year recurrence-free survival rate as low as 35% after resection (Reveron‐Thornton et al., 2022).

As a result, modern therapies have been heavily focused on a molecular basis. Because of the extreme heterogeneity of HCC, so called ‘regional therapies’ are often more precise and effective but can also be riskier. As such, it is important that we identify a suitable systemic treatment for the condition that is both safe and effective (Tomášek & Kiss, 2020).

Immunotherapy and its Future in HCC Treatment

In an anti-tumour response, Natural Killer (NK) cells are the first line of defence. However, during the progression of HCC, the tumour microenvironment incorporates countless mechanisms to interrupt NK cell function. NK cell immunotherapy shows promising results. NK cells that are isolated from a donor graft and subsequently stimulated by IL-2 shows an increase in anti-tumour efficiency (Che et al., 2026).

NK cell-based therapies are also emerging in the form of genetic engineering. Chimeric antigen receptor-engineered NK (CAR-NK) show promising results, with a lower chance of autoimmunity. Since CAR-NK cells have a lower half-life than the more common CAR-T cell-based therapies. Other studies have also shown that genetically engineered chemokine receptors have increased the efficacy of NK cells in locating and destroying tumour cells (Che et al., 2026).

Prevention Strategies for HCC

Given the several key risk factors that are at play in HCC, several preventative strategies exist to lower the risk of developing HCC. For starters, vaccination against Hepatitis B is commonplace, and can help reduce the risk of HCC development from the virus. Some individuals may not be able to receive the vaccine, and in such cases, herd immunity is critical to protect the immunocompromised or unvaccinated population. However, Hepatitis C is a slightly more complicated case, as a Hepatitis C vaccine currently does not exist.  As such, to prevent Hepatitis C we must engage proper sterilization in healthcare environments, and all exercise proper hygiene. If a person is already infected with Hepatitis B or C, several antiviral treatments may be administered to significantly lower the risk of HCC (Yang et al., 2019).

Further knowing that fatty liver disease is a primary risk factor for HCC, certain lifestyle changes such as avoiding heavy alcohol consumption or calorie-high diets can also significantly alleviate the risk (Yang et al., 2019).

Summary and Conclusion

HCC is one of the deadliest forms of cancer, responsible for 90% of liver disease mortality internationally. Its extreme heterogeneity poses difficult challenges for the development of standard molecular treatments. Though typical treatments such as surgical resection are possible, their 5-year recurrence-free survival rate is low. As such, immunotherapy using CAR-NK cells is a promising development within the field. Individuals may avoid heavy alcohol consumption and calorie-heavy diets. If you can receive the vaccine, ensuring their Hepatitis B vaccination is up to date can also significantly reduce the risk of HCC. Consulting your general practitioner is a good idea when you are looking for more information regarding prevention strategies that are possible for you.

References

Alawyia, B., & Constantinou, C. (2023). Hepatocellular Carcinoma: a Narrative Review on Current Knowledge and Future Prospects. Current Treatment Options in Oncology, 24(7), 711–724. https://doi.org/10.1007/s11864-023-01098-9

Che, L., Xie, X., Yang, X., Zhu, S., & Zhou, Y. (2026). Natural Killer Cell‐Based Immunotherapy in <scp>HCC</scp>. Immunology. https://doi.org/10.1111/imm.70141

Reveron‐Thornton, R. F., Teng, M. L. P., Lee, E. Y., Tran, A., Vajanaphanich, S., Tan, E. X., Nerurkar, S. N., Ng, R. X., Teh, R., Tripathy, D. P., Ito, T., Tanaka, T., Miyake, N., Zou, B., Wong, C., Toyoda, H., Esquivel, C. O., Bonham, C. A., Nguyen, M. H., & Huang, D. Q. (2022). Global and regional long‐term survival following resection for HCC in the recent decade: A meta‐analysis of 110 studies. Hepatology Communications, 6(7), 1813–1826. https://doi.org/10.1002/hep4.1923

Tomášek, J., & Kiss, I. (2020). Hepatocellular carcinoma future treatment options. Klinicka Onkologie, 33(Suppl 3). https://doi.org/10.14735/amko20203S26

Yang, J. D., Hainaut, P., Gores, G. J., Amadou, A., Plymoth, A., & Roberts, L. R. (2019). A global view of hepatocellular carcinoma: trends, risk, prevention and management. Nature Reviews Gastroenterology & Hepatology, 16(10), 589–604. https://doi.org/10.1038/s41575-019-0186-y

Assessed and Endorsed by the MedReport Medical Review Board