Published online Apr 15, 2021. doi: 10.4251/wjgo.v13.i4.197
Peer-review started: December 21, 2020
First decision: January 11, 2021
Revised: January 14, 2021
Accepted: March 11, 2021
Article in press: March 11, 2021
Published online: April 15, 2021
Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths worldwide. The prognosis of patients with HCC remains poor largely due to the late diagnosis and lack of effective treatments. Despite being widely used, alpha-fetoprotein serology and ultrasonography have limited diagnostic performance for early-stage HCC. The emergence of omics strategies has contributed to significant advances in the development of non-invasive biomarkers for the early diagnosis of HCC including proteins, metabolites, circulating tumor deoxyribonucleic acid, and circulating non-coding ribonucleic acid. Early diagnosis is beneficial to patients as it increases the proportion who can be treated with curative treatment, thus prolonging survival outcomes. Currently, multiple clinical trials involving locoregional, systemic therapies, and combinations of these modalities are changing therapeutic strategies for different stage HCC. Success in several preclinical trials that involve immunotherapeutic innovations has created the potential to complement and enforce other treatment strategies in the future. This review summarizes the most recent advances in non-invasive early molecular detection, current therapy strategies, and potential immunotherapeutic innovations of HCC.
Core Tip: Long-term survival relies upon early diagnosis and timely treatment for patients with hepatocellular carcinoma (HCC). In this review, an update on the non-invasive early molecular detection and therapeutic strategies associated with HCC is discussed, focusing on omics-related biomarkers (e.g., proteins, metabolites, circulating tumor deoxyribonucleic acid, circulating non-coding ribonucleic acid), locoregional and systemic therapies for treating different stages of HCC, as well as potential immunotherapeutic innovations (e.g., adoptive cell transfer therapy).