Systemic treatment for advanced hepatocellular carcinoma of non-viral causes

As the most frequent primary hepatic malignancy and the third cause of cancer-related death, hepatocellular carcinoma (HCC) occurs primarily in cases of underlying chronic liver disease, being infection with hepatitis B and C the main cause. However, there are other relevant risk factors that contribute as well, such as non-alcoholic fatty liver disease (NAFLD) and its progressive subtype non-alcoholic steatohepatitis (NASH), obesity and diabetes among others. Currently there are several agents available for the systemic treatment of HCC and the guidelines support atezolizumab plus bevacizumab as the first-line therapy. However, some data show that non-viral HCC might benefit less from the treatment with immunotherapy. This article reviews the systemic treatment for advanced HCC focusing more on the results for non-viral causes.