Published online Mar 9, 2015. doi: 10.5497/wjp.v4.i1.96
Peer-review started: July 29, 2014
First decision: September 18, 2014
Revised: November 13, 2014
Accepted: November 27, 2014
Article in press: December 1, 2014
Published online: March 9, 2015
Hepatocellular carcinoma (HCC) is the most frequent form of liver cancer and the third most common cause of cancer-related death in the world. The main risk factor worldwide for this type of malignancy is chronic hepatitis caused by hepatitis B virus and hepatitis C virus infections. Advances in early detection and treatment have improved life expectancy of patients with HCC. However, this disorder remains as a disease with poor prognosis. In fact, epidemiological studies have revealed that there is an 8-mo median survival rate in patients, approximately 20% of whom survive one year while only 5% remain alive after three years. Additionally, HCC is particularly difficult to treat because of its high recurrence rate, and its resistance to conventional chemotherapy is due, among other mechanisms, to several members of the ATP-Binding Cassette protein family involved in drug transport being overexpressed. Fortunately, there is evidence that these patients may benefit from alternative molecular-targeted therapies. This manuscript intends to provide further insight into the etiology and molecular mechanisms related to HCC development and the latest therapeutic approaches to treat this malignancy. The development of effective delivery systems of antitumor drugs able to target the liver parenchyma is also assessed. Finally, the prospects in the development of more efficient drug therapies to overcome multidrug resistance are also examined.
Core tip: Hepatocellular carcinoma (HCC) is the most frequent malignancy of the liver. Despite the advances in early detection and treatment, this disorder still has a poor prognosis. This manuscript reviews the ongoing knowledge regarding the etiology and molecular mechanisms implicated in HCC development and the therapeutic strategies for the management of this malignancy. Finally, the development of effective delivery systems of antitumor drugs able to target the liver parenchyma as well as the prospects in the development of a more efficient drug therapy to overcome multidrug resistance are also examined.