While HCC is the 6th most common cancer in the world and afflicts almost a million people yearly, it is the 2nd most important cause of cancer death. There is great geographical variation in the distribution of HCC with 80% of the burden found in the Asia-Pacific region. In Asia, it is the 3rd most common cancer. While surgical resection (and in some cases, liver transplantation) offers patients with HCC the most consistent and significant survival advantage, only less than 20% of these patients are diagnosed early enough to undergo surgical resection as a curative therapy.
About 30% of inoperable patients may benefit from existing therapies that prolong life but the outcome and survival of the remaining inoperable patients remains grave. Even with surgical resection, long term survival of HCC patients has remained unsatisfactory due to recurrent carcinoma and progressive liver disease. Chemoprevention in patients at high risk for HCC has also not been clearly established. There is thus an urgent need for more clinical trials in HCC (palliative, adjuvant and chemoprevention) to develop new and efficacious therapies, especially in parts of the world where the disease burden is highest. Pivotal clinical studies are required to change clinical practice and actualize precision oncology in HCC to improve patient outcomes.
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