Liver cancer — most often hepatocellular carcinoma — typically develops in the setting of cirrhosis caused by hepatitis B or C, alcohol use, or fatty liver disease. Treatment has improved markedly in recent years, and combination regimens are achieving responses that were rare just a decade ago.
What's actually going on in research
Combining immune checkpoint inhibitors with anti-VEGF antibodies (like atezolizumab plus bevacizumab) has become first-line therapy for advanced liver cancer and dramatically changed survival expectations. Trials are now testing these combinations against each other, pairing them with additional agents, and moving them into earlier-stage disease before and after local treatments. Local therapies — including drug-eluting beads, radioembolization, and ablation — are being combined with systemic immunotherapy to extend their benefit.
Checkpoint plus anti-VEGF
Combining immune activation (checkpoint inhibitors) with anti-angiogenic drugs that cut tumor blood supply has become standard for advanced disease, with trials testing newer combinations.
Local-systemic combinations
Chemoembolization, radioembolization (Y-90), and ablation are being combined with systemic immunotherapy in trials to see if local treatment amplifies immune responses.
Locoregional innovation
New delivery methods — including drug-eluting microspheres and stereotactic body radiation — are being compared head-to-head and tested in patients who are not surgical candidates.
What to know before you search
Eligibility depends on underlying liver function (Child-Pugh score), prior local treatments, AFP levels, hepatitis status, and performance status.
What types of trials are currently open
- Treatment trials — Testing new systemic regimens or immunotherapy combinations in advanced hepatocellular carcinoma.
- Locoregional trials — Evaluating new embolization, ablation, or radiation techniques for intermediate-stage disease.
- Adjuvant trials — Testing systemic therapy after surgical resection or transplant to prevent recurrence.
- Prevention trials — Testing antiviral therapy and surveillance strategies to prevent liver cancer in high-risk populations.
- Observational studies — Tracking outcomes across treatment modalities and liver disease severity levels.
Recently added Liver Cancer trials
Ipilimumab N01 Combined With Sintilimab, Bevacizumab Biosimilar, and Hepatic Arterial Infusion Chemotherapy as Conversion Therapy for Unresectable Intermediate-Advanced Hepatocellular Carcinoma
Conversion therapy for unresectable intermediate-advanced hepatocellular carcinoma (uHCC) has evolved from systemic therapy to combined local-systemic approaches, but current regimens still have limited surgical conversion rates. This prospective, single-arm phase II study evaluates a combination regimen of PD-1 inhibitor (sintilimab) plus CTLA-4 inhibitor (ipilimumab N01), bevacizumab biosimilar, and HAIC for patients with initially unresectable intermediate-advanced HCC. The primary goal is to achieve a higher surgical conversion rate with manageable safety
SHIELD: Sorafenib Hand-foot Syndrome Inhibition With Pre-Emptive Local Delivery of Topical Indomethacin
SHIELD is a single-center, open-label, single-arm prospective study designed to evaluate whether pre-emptive topical indomethacin can reduce sorafenib-associated hand-foot syndrome (HFS) in patients with advanced hepatocellular carcinoma (HCC). Eligible adult patients with advanced HCC who are planned to initiate sorafenib will receive standard sorafenib treatment together with prophylactic 1% topical indomethacin gel applied to both hands twice daily for up to 12 weeks, or until development of HFS or discontinuation of sorafenib, whichever occurs first. The primary endpoint is the incidence of all-grade HFS during the first 12 weeks of sorafenib treatment. Secondary endpoints include grade 2 or higher HFS rate, grade 3 or higher HFS rate, mean sorafenib dose intensity during the first 12 weeks, adverse events of special interest, and duration of sorafenib treatment. The study will enroll 39 patients and compare outcomes with historical control data.
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