Systemic Therapies in Hepatocellular carcinoma: present and future

Hepatocellular carcinoma (HCC) is now the third leading cause of cancer deaths worldwide, generally presented at an advanced stage limiting patients expectation of life.. The conventional cytotoxic systemic therapy is ineffective in HCC, since the last decades. Today it’s possible to use our knowledge of molecular hepatocarcinogenesis and provide a targeted therapy.. Sorafenib is a demonstration of the improvement in overall survival in HCC. This review describes the molecular mechanisms and potential therapeutic targets focusing on Sorafenib, Sunitinib, Tivantinib, antiangiogenic agents, and to current and future immunotherapy. . Thus, it will be necessary in the future to classify HCCs into subgroups according to their genomic and proteomic profiling. The identification of key molecules/receptors/signaling pathways and the assessment of their relevance as potential targets will be the main future challenge potentially influencing response to therapy. Defining molecular targeted agents effective for a specific subgroup will hopefully lead to personalized therapy.