ABSTRACT
For hepatocellular carcinoma (HCC) that has advanced to the point that it is no longer
amenable to local therapies, systemic therapy can be considered in select patients
who have a good performance status. No systemic therapy has been clearly shown to
improve overall survival compared with supportive care alone, although cancer-related
symptoms can sometimes be palliated with therapy and some objective responses are
seen. Systemic therapies for HCC include chemotherapy, both intravenous and infused
via the hepatic artery, as well as hormonal therapy, immunotherapy, and targeted biologic
agents. Colorectal, pancreatic, breast, and lung cancer are some of the most common
tumors that metastasize to the liver. Response rates and effect on overall survival
as a result of systemic therapy for liver metastases vary widely depending on primary
tumor site. Targeted biologic agents are being integrated into standard treatment
regimens for all of these cancer types, with variable effects on survival and other
outcomes for all affected patients including those with liver metastases.
KEYWORDS
Hepatocellular carcinoma - chemotherapy - systemic therapy - liver metastases
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Kevin S. BrownM.D.
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