Your recommended treatment plan for liver cancer will depend on a number of factors. These include what type of liver cancer you have, whether the cancer has spread, and your overall health.
Your healthcare provider may recommend a variety of treatments, such as:
- targeted therapy
- radiation therapy
- ablation therapy
- embolization therapy
Scientists are continually developing and testing new treatment approaches for liver cancer to help improve survival and quality of life.
Here are a few of the most notable recent developments in liver cancer treatments and research.
In May 2020, the Food and Drug Administration (FDA) approved a new combination of medications to treat a common type of liver cancer known as hepatocellular carcinoma (HCC).
Specifically, the FDA approved the combination of atezolizumab (Tecentriq) plus bevacizumab (Avastin) to treat HCC that has spread or can’t be treated through surgery.
Tecentriq is a type of immunotherapy known as an immune checkpoint inhibitor. It helps guide the immune system to find and kill cancer cells.
Avastin is a type of targeted therapy that helps block the growth of new blood vessels in tumors. This may cause the tumors to shrink.
A 2020 study found that the combination of Tecentriq plus Avastin was more effective than sorafenib (Nexavar) alone for treating advanced HCC. Nexavar is another type of targeted therapy that blocks the growth of blood vessels in tumors.
Experts have been studying other combinations of medications for liver cancer.
For example, the FDA recently approved nivolumab (Opdivo) plus ipilimumab (Yervoy) for treating advanced HCC in people who have previously taken Nexavar.
Opdivo and Yervoy are checkpoint inhibitors that help guide the body’s immune response to cancer.
Ablation is a procedure that’s used to destroy tumors. It’s generally used to treat small liver tumors that surgery can’t easily remove.
There are several types of ablation:
- Radiofrequency ablation (RFA) and microwave ablation (MWA) use high-energy waves to heat and destroy tumors.
- Cryoablation uses cold gasses to freeze and kill cancer cells.
- Ethanol ablation involves an injection of concentrated alcohol into tumors to kill cancer cells.
- Irreversible electroporation is currently being studied for the treatment of liver cancer. It uses high-voltage electricity to open pores in cancer cells, which causes the cells to die.
A 2019 review of studies suggested that irreversible electroporation may be more effective than other ablation techniques for treating small and very early stage liver cancer tumors that are located in hard to treat areas.
Researchers have also been combining more conventional ablation techniques with other therapies for treating liver cancer.
A 2020 study in mice found that combining RFA with the targeted therapy sunitinib (Sutent) was more effective than using RFA or Sutent alone.
Radiation therapy uses high-energy particles to kill cancer cells. It may be used to treat liver cancers that surgery can’t remove in people whose livers have been damaged by conditions including cirrhosis or hepatitis.
External beam radiation therapy (EBRT) is a form of radiation therapy used to treat liver cancer:
- Photon beam radiation therapy is the standard type of EBRT. It uses X-rays, or beams of photons, produced by a machine called a linear accelerator.
- Proton beam radiation therapy is a newer type of EBRT that uses proton beams. Protons are parts of atoms that are effective at killing cancer cells with less damage to surrounding tissues.
Some research suggests that proton beam therapy may be safer than and as effective as photon beam therapy.
Because it causes less damage to healthy tissues, healthcare providers may be able to give higher doses of radiation with lower risk of side effects.
Scientists are currently conducting a phase 3 clinical trial to compare the photon beam radiation with proton beam radiation in liver cancer.
In addition to developing new treatments and combinations of therapies, researchers are also working to discover which people are most likely to benefit from various treatment approaches for liver cancer.
This is known as precision medicine. The goal is to create customized treatment plans that are tailored to people with certain types of tumors.
Precision medicine involves identifying specific genes or molecules in tumors that could help scientists predict how the tumors will respond to different treatments.
These genes or molecules are also known as biomarkers or tumor markers. If experts can identify these reliable biomarkers, it may help reduce the trial and error involved in developing treatment plans.
New combinations of medications have recently been approved to treat liver cancer. Researchers are also studying other medications, procedures, and combination therapies for managing this disease.
Your healthcare provider can help you learn about potential benefits and risks of different treatment approaches, including new treatments that have recently become available.
If your healthcare provider thinks you might benefit from receiving an experimental treatment that’s currently being studied, they might encourage you to enroll in a clinical trial.