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Liver Cancer

Diagnosis and tests, prevention and risk factors, treatments and therapies, living with, related issues, see, play and learn.

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Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Primary liver cancer starts in the liver. Metastatic liver cancer starts somewhere else and spreads to your liver.

Risk factors for primary liver cancer include :

Symptoms can include a lump or pain on the right side of your abdomen and yellowing of the skin. However, you may not have symptoms until the cancer is advanced. This makes it harder to treat. Doctors use tests that examine the liver and the blood to diagnose liver cancer. Treatment options include surgery, radiation, chemotherapy, or liver transplantation .

NIH: National Cancer Institute

From the National Institutes of Health

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Liver Cancer

What's New in Liver Cancer Research?

Ablation therapy

Targeted therapy, virus therapy.

Because there are only a few effective ways to prevent or treat liver cancer at this time, there is always a great deal of research going on in the area of liver cancer. Scientists are looking for causes and ways to prevent liver cancer, as well as ways to improve treatments.

Some scientists believe that vaccinations and improved treatments for hepatitis could prevent about half of liver cancer cases worldwide. Researchers are studying ways to prevent or treat hepatitis infections before they cause liver cancers. Research into developing a vaccine to prevent hepatitis C is ongoing. Progress is also being made in treating chronic hepatitis.

Several new blood tests are being studied to see if they can detect liver cancer earlier than using   AFP and ultrasound . Ones being studied include DCP, Glypican-3, osteopontin and Golgi protein-73. CT scans and MRI scans are also being studied as different imaging tests to screen for liver cancer instead of ultrasound.

Newer techniques are being developed to make both partial hepatectomy and liver transplants safer and more effective.

Adding other treatments to surgery

An active area of research uses adjuvant therapies – treatments given right after surgery – to try to reduce the chances that the cancer will return. Most of the studies so far using chemotherapy or chemoembolization after surgery have not shown that they help people live longer. Research studies are also looking into newer drugs, like targeted therapy and may prove to be more effective. Some promising results have also been seen with radioembolization , but these need to be confirmed in larger studies. Another area studied has been the use of anti-viral therapy in people with liver cancer related to having viral hepatitis to see if it improves outcomes after surgery.

Doctors are also studying ways to make more liver cancers resectable by trying to shrink them before surgery. Studies are now looking at different types of neoadjuvant therapies (therapies given before surgery), including targeted therapy, chemotherapy, ablation, embolization, and radiation therapy. Early results have been promising but have only looked at small numbers of patients.

Determining recurrence risk after surgery

After a partial hepatectomy, one of the biggest concerns is that the cancer might come back (recur). Knowing someone's risk for recurrence after surgery might give doctors a better idea of how best to follow up with them, and may someday help determine who needs additional treatment to lower this risk.

Researchers are studying ways to predict if the cancer will come back by testing the liver cells in the surgery sample through genetic profiling. These studies are promising but will need to be confirmed in other larger studies before it is widely used.

Newer ablation techniques are being studied. One type, called irreversible electroporation, is an ablation procedure that does not use heat or cold to destroy cancer cells. It uses high voltage to open the "pores" of the cell (like the pores of your skin) which causes the cancer cells to die. It may be very useful for cancers that are in difficult areas to treat, such as near blood vessels.

New drugs have been developed that work differently from standard chemotherapy drugs. These new targeted drugs act on specific proteins in cancer cells or their surrounding environments.

Tumor blood vessels are the target of several newer drugs. Liver tumors need new blood vessels to grow. The drug sorafenib (Nexavar), which is already used for some liver cancers that can't be removed surgically, works in part by hindering new blood vessel growth. This drug is now being studied for use earlier in the course of the disease, such as after surgery or trans-arterial chemoembolization (TACE). Researchers are also studying whether combining it with chemotherapy may make it more effective.

Ramucirumab (Cyramza) is another targeted drug that works on blocking new blood vessel growth which can result in tumor shrinkage. It is already being used in other cancers such as stomach cancer, NSCLC and colorectal cancer. It is being studied in people with liver cancer with positive results.

Knowing which liver cancers will respond to certain treatments before giving them would help save people from side effects of unhelpful drugs. Research is being done to look for specific biomarkers (proteins) such as p-ERK, or genomic profiling (specific gene changes of a cancer) to see if targeted therapy or immunotherapy can be chosen based a tumor's special traits.

A newer approach to treatment is the use of a virus, known as JX-594 . This started as the same virus that was used to make the smallpox vaccine, but it has been altered in the lab so that it mainly infects cancer cells and not normal cells. A solution containing the virus is injected into liver cancers, and the virus can enter the cancer cells, where it causes them to die or to make proteins that result in them being attacked by the body’s immune system. Early results of this treatment against advanced liver cancer have been promising, even in patients who have already had other treatments.

research article about liver cancer

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Abou-Alfa GK, Jarnigan W, Dika IE, D’Angelica M, Lowery M, Brown K, et al. Ch. 77 - Liver and Bile Duct Cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology . 6th ed. Philadelphia, Pa: Elsevier; 2020:1314–1341.

Brawley OW and Parnes HL. Ch. 37 - Cancer Screening. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology . 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019:-454-470.

Colombo M and Sirlin CB. Surveillance for hepatocellular carcinoma in adults. UpToDate website. Updated September 17, 2018. Accessed March 12, 2019.

Heo J, Reid T, Ruo L, et al. Randomized dose-finding clinical trial of oncolytic immunotherapeutic vaccinia JX-594 in liver cancer. Nat Med . 2013 Mar;19(3):329-336. Epub 2013 Feb 10.

Hoshida Y, Villanueva A, Kobayashi M, et al. Gene expression in fixed tissues and outcome in hepatocellular carcinoma. N Engl J Med . 2008;359:1995–2004.

Kudo M. Targeted and immune therapies for hepatocellular carcinoma: Predictions for 2019 and beyond. World J Gastroenterol . 2019;25(7):789-807.

National Cancer Institute. Physician Data Query (PDQ). Adult Primary Liver Cancer Treatment. Accessed at on March 13, 2019.

Ocker M. Biomarkers for hepatocellular carcinoma: What's new on the horizon?. World J Gastroenterol . 2018;24(35):3974-3979.

Rauol JL, Kudo M, Edeline J, Galle PR. Systemic therapy for intermediate and advanced hepatocellular carcinoma: Sorafenib and beyond. Cancer Treat Rev. 2018 Jul;68:16-24. doi: 10.1016/j.ctrv.2018.05.006. Epub 2018 May 26.

Salati U, Barry A, Chou FY, Ma R, Liu DM. State of the ablation nation: a review of ablative therapies for cure in the treatment of hepatocellular carcinoma. Future Oncol. 2017 Jul;13(16):1437-1448. doi: 10.2217/fon-2017-0061. Epub 2017 Jul 7.   

Tenneti P, Borad MJ, Babiker HM. Exploring the role of oncolytic viruses in hepatobiliary cancers. Immunotherapy . 2018 Aug;10(11):971-986. doi: 10.2217/imt-2018-0048. Epub 2018 Jun 14.

Tsuchiya N, Sawada Y, Endo I, Saito K, Uemura Y, Nakatsura T. Biomarkers for the early diagnosis of hepatocellular carcinoma. World J Gastroenterol . 2015;21(37):10573-83.

Yin J, Li N, Han Y, et al. Effect of antiviral treatment with nucleotide/nucleoside analogs on postoperative prognosis of hepatitis B virus-related hepatocellular carcinoma: a two-stage longitudinal clinical study . J Clin Oncol . 2013 Oct 10;31(29):3647−3655. Epub 2013 Sep 3.

Zhang CH, Xu GL, Jia WD, Ge YS. Effects of interferon alpha treatment on recurrence and survival after complete resection or ablation of hepatocellular carcinoma: A meta-analysis of randomized controlled trials. Int J Cancer . 2009;124:2982–2988.

Zhong C, Guo RP, Li JQ, et al. A randomized controlled trial of hepatectomy with adjuvant transcatheter arterial chemoembolization versus hepatectomy alone for Stage IIIA hepatocellular carcinoma. J Cancer Res Clin Oncol . 2009;135:1437–1445.

Zhu AX, Kang YK, Yen CJ, Finn RS, Galle PR, Llovet JM, et al. Ramucirumab after sorafenib in patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations (REACH-2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019 Feb;20(2):282-296.

Last Revised: April 1, 2019

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy .

More in Liver Cancer

Help us end cancer as we know it, for everyone.

Liver and Bile Duct Cancer Research Results and Study Updates

See Advances in Liver Cancer Research for an overview of recent findings and progress, plus ongoing projects supported by NCI.

Researchers have developed a blood test that, in a preliminary study, accurately detected liver cancer, including in people with early-stage disease. The test uses a new type of technology called fragmentomics to analyze bits of DNA in the blood.

For some people with hepatocellular carcinoma (HCC), the most common type of liver cancer, a liver transplant is the only hope for a cure. A new study shows a high 10-year survival rate for people who got a liver transplant after their tumors were “downstaged” to become eligible for a transplant.

Adding durvalumab (Imfinzi) to standard chemotherapy modestly extended how long people with advanced biliary tract cancer lived, results from the TOPAZ-1 trial show. The immunotherapy drug may now be the standard first-line therapy for this hard-to-treat cancer.

Researchers have found that mice that lack β2-spectrin protein in their livers are protected from nonalcoholic fatty liver disease and the most common kind of liver cancer, hepatocellular carcinoma.

The new test is relatively simple and could improve screening for people who are at risk for developing hepatocellular carcinoma (HCC), the most common form of liver cancer. It could help doctors find and treat HCC early.

FDA has approved atezolizumab (Tecentriq) plus bevacizumab (Avastin) as an initial treatment for some people with advanced liver cancer. This is the first approval in 13 years for a treatment that is more effective than the current standard, sorafenib.

Some children with liver cancer may need less chemotherapy than is typically used, new research suggests. The study included children and infants with hepatoblastoma whose tumors had been surgically removed when the disease was diagnosed.

Researchers have found an unconventional way to unleash the immune system against liver cancer in mice. The researchers used an investigational drug to curb the production of a checkpoint inhibitor protein that shields tumors from the immune system.

In an early-phase trial, dabrafenib plus trametinib shrank tumors in patients with biliary tract cancer and adenocarcinoma of the small intestine whose tumors had a specific mutation in the BRAF gene.

An NCI study in mice that found a connection between gut bacteria and antitumor immune responses in the liver has implications for understanding mechanisms that lead to liver cancer and for potential treatments. The study was published in Science.

The FDA has granted accelerated approval to the immunotherapy drug nivolumab (Opdivo®) for patients with advanced liver cancer who have previously been treated with the targeted therapy sorafenib (Nexavar®).

Only two drugs are FDA-approved for liver cancer. This study of hepatocellular carcinoma found genetic alterations in tumors—including mutations in tumor-suppressing genes and high expression of immune checkpoint genes—that could be targets for drugs that already exist.

FDA approved the kinase inhibitor regorafenib for some patients with hepatocellular carcinoma, the most common form of liver cancer.


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