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Invited Commentary
May 2018

Hepatocellular Carcinoma With Portal Venous InvasionRadiating New Hope?

Author Affiliations
  • 1Charles T. Dotter Department of Interventional Radiology, Oregon Health & Science University, Portland
  • 2Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston
JAMA Oncol. 2018;4(5):669-670. doi:10.1001/jamaoncol.2018.0007

The growing incidence of hepatocellular carcinoma (HCC) is a major global public health challenge. The mortality rate for HCC is very high, and most available treatment options remain palliative. Early-stage HCC can be treated with curative intent with transplantation, resection, or ablation. Level 1 evidence from randomized clinical trials has demonstrated a survival advantage for transarterial chemoembolization (TACE) vs supportive care for intermediate-stage HCC1 and for systemic therapy with sorafenib, lenvatinib, regorafenib, and cabozantinib for advanced-stage HCC.1,2 Recently, immune checkpoint inhibitors have demonstrated impressive antitumor activity with high response rates in advanced HCC, and phase 3 trials are ongoing to assess survival benefits.3,4