New Treatments & Clinical Trials for Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and one of the few cancers still rising in incidence in many countries, driven by fatty liver disease. While it was long considered difficult to treat in advanced stages, the past several years have brought a wave of effective systemic therapies.

What's actually going on in research

Combination immunotherapy — pairing checkpoint inhibitors with anti-angiogenic drugs — has become the standard of care for advanced HCC and is now being tested in earlier disease settings after surgery or transplant. New targets including TIGIT, LAG-3, and VEGFR are being added to first-line regimens to deepen and extend responses. Cell-based therapies and therapeutic cancer vaccines are in early trials, aiming to train the immune system to recognize HCC-specific antigens.

What to know before you search

Eligibility depends on liver function (Child-Pugh class), tumor burden, prior local or systemic therapy, AFP levels, and BCLC staging.

What types of trials are currently open

• Treatment trials — Testing new systemic drug combinations in unresectable or metastatic HCC.
• Adjuvant trials — Testing post-resection or post-ablation therapy to lower recurrence risk.
• Locoregional trials — Comparing embolization, ablation, and radiation techniques for intermediate-stage disease.
• Transplant trials — Expanding eligibility criteria and testing bridging therapies for patients awaiting liver transplant.
• Prevention trials — Testing surveillance programs and antiviral therapy in high-risk cirrhosis patients.