Rzeniewicz K, Sharma R. Systemic treatment of hepatocellular carcinoma secondary to non-alcoholic fatty liver disease. World J Clin Oncol 2024; 15(11): 1394-1403 [PMID: 39582617 DOI: 10.5306/wjco.v15.i11.1394]
Corresponding Author of This Article
Rohini Sharma, Doctor, FRACP, MBBS, Professor, Senior Lecturer, Department of Surgery and Cancer, Hammersmith Hospital, 72 Du Cane Road, London W12 0NN, United Kingdom. r.sharma@imperial.ac.uk
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Nov 24, 2024; 15(11): 1394-1403 Published online Nov 24, 2024. doi: 10.5306/wjco.v15.i11.1394
Systemic treatment of hepatocellular carcinoma secondary to non-alcoholic fatty liver disease
Karolina Rzeniewicz, Rohini Sharma
Karolina Rzeniewicz, Rohini Sharma, Department of Surgery and Cancer, Hammersmith Hospital, London W12 0NN, United Kingdom
Author contributions: Rzeniewicz K and Sharma R conceptualised the manuscript; Rzeniewicz K wrote the first draft; Sharma R critically reviewed and revised the manuscript. Both authors agreed on the submission journal, approved all versions of the manuscript, and agree to take accountability for its content.
Conflict-of-interest statement: Sharma R received consulting fees for SIRTEX, Esai; research funding (to institution) from Novartis, Astex Pharmaceuticals, Terumo and Boston Scientific. Rzeniewicz K has no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rohini Sharma, Doctor, FRACP, MBBS, Professor, Senior Lecturer, Department of Surgery and Cancer, Hammersmith Hospital, 72 Du Cane Road, London W12 0NN, United Kingdom. r.sharma@imperial.ac.uk
Received: March 22, 2024 Revised: May 29, 2024 Accepted: August 5, 2024 Published online: November 24, 2024 Processing time: 205 Days and 8.8 Hours
Abstract
Hepatocellular carcinoma (HCC) is the third leading cause of cancer death globally, with 15% of cases arising on a background of non-alcoholic fatty liver disease (NAFLD). NAFLD is a heterogenous condition ranging from fatty liver to cirrhosis and is itself a growing global problem, with estimated worldwide prevalence of 50% in 2040. Pathophysiology of NAFLD-HCC is not well understood, there are no dedicated screening programs, and there have been no clinical studies of anti-cancer treatments in this population specifically. However, the NAFLD-HCC population appears different than other aetiologies - patients tend to be older, diagnosed at more advanced stages, have more comorbidities, and overall worse prognosis. Understanding of best treatment options for this group of patients is an urgent unmet clinical need. This narrative review discusses NAFLD-HCC pathophysiology and systemic treatment, and offers suggestions for future directions in this therapy area.
Core Tip: Hepatocellular carcinoma (HCC) arising on a background of non-alcoholic fatty liver disease (NAFLD) is not well understood but patients tend to have poorer prognosis vs those with other HCC aetiologies. Currently all HCC patients are treated the same regardless of aetiology, and understanding of best treatment options for the NAFLD-HCC population is an urgent clinical need. This narrative review discusses NAFLD-HCC screening, pathophysiology, systemic treatment, and offers suggestions for future directions in this therapy area.
