Overview
Liver cancer is a life-threatening illness and one of the fastest-growing cancer types in the United States. It is estimated that around 1% of people in the United States will be diagnosed with a form of liver cancer during their lifetime. There are several types of primary liver cancer: hepatocellular carcinoma (HCC), intrahepatic cancer (IHC), and angiosarcoma, where HCC and IHC account for about 2% of all newly diagnosed cancer cases in the USA and 5% of all new cancer deaths. Cirrhosis related to HBV and HCV is suggested to be responsible for more than half of all HCC cases.
Fig.1. Liver cancer cells
Clinical
Liver cancer develops when liver cells undergo mutations in their DNA. The mutations in oncogenes and tumor suppressor genes can lead to cancer. Certain chemicals such as aflatoxins can damage the TP53 gene in liver cells and cause tumor development. In addition, hepatitis viruses can also change DNA when they infect the liver cells, thereby turning on the cell’s oncogenes. Except for the genetic mutations, some certain diseases including chronic infection with HBV or HCV, diabetes, nonalcoholic fatty liver disease, cirrhosis, as well as certain inherited liver diseases may also increase the risk of developing liver cancers.
Diagnosis
Liver cancer may develop with no symptoms in the early stage. Related physical examinations include Blood tests, imaging tests, lab tests, and biopsies of liver tissue.
Treatment
Treatments for HCC and IHC are very similar, including surgery removal, liver transplantation, and liver-directed treatments such as ablation. Chemotherapy, radiation therapy, immunotherapy and targeted therapy are also suggested depending on the stage of the cancer as well as the age, overall health conditions and personal preferences.
Due to the fact that standard chemotherapy is not very effective in most patients with liver cancer, targeted drug therapy has been gaining more attraction now. Kinase inhibitors can block several kinase proteins which work to help tumor cells grow. Inhibitors like sorafenib (Nexavar), regorafenib (Stivarga) and cabozantinib (Cabometyx) and commonly used kinase inhibitors for liver cancer treatment. In addition, several monoclonal antibodies including bevacizumab (Avastin) and ramucirumab (Cyramza) are also used.
Immunotherapy works by boost your own immune system to fight cancer. It is generally reserved for patients with advanced liver cancer. Immune checkpoint inhibitors (ICIs) have been widely used for liver cancer treatment. PD-1/PD-L1 inhibitors including Atezolizumab, Pembrolizumab and Nivolumab are normally used. In addition, CTLA-4 inhibitors like lpilimumab also works on cancer treatment by boosting the immune response.
Related Targets
ACE,AFP,AFP-L3,ANGPT2,ANXA2,CDH1,CDH2,CTLA4,CTNNB1,EpCAM,FUT4,GOLM1,GPC3,HAVCR2,HGF,HSP70,IGF1,IL8,KRT18,KRT19,KRT20,KRT7,KRT8,LAG3,MDK,MET,PDCD1,PROM1,SCCA,SPP1,suPAR,TGFB,THY1,TP53,TRX,TTF1,VEGF,VIM
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