Editor’s Note: Liver cancer is a major global health threat, and ongoing exploration into treatment strategies remains a focal point in medical research. From October 17 to 19, 2024, top experts and scholars in the field of liver cancer gathered in Toronto, Canada, for the 18th International Liver Cancer Association (ILCA) Annual Meeting. This conference brought together leading researchers from around the world to discuss the latest progress and future directions in liver cancer treatment. Oncology Frontier invited Dr. Guohong Han, Executive Dean of the Digestive Hospital at Xi’an International Medical Center Hospital, to provide an insightful interpretation of the conference highlights.

Systemic Treatment for Advanced Liver Cancer: Biomarker Exploration and Challenges

Systemic treatment for advanced liver cancer was a key topic at ILCA, with studies like the IMbrave150 and HIMALAYA providing significant evidence for combination therapies involving targeted therapy and immunotherapy. However, identifying appropriate biomarkers to predict treatment efficacy remains a challenging task. Biomarkers are crucial in advanced liver cancer treatment, allowing physicians to predict patient response, select those most likely to benefit, and develop personalized treatment plans. While researchers are rigorously analyzing large patient data sets to uncover gene and protein markers closely linked to treatment response, definitive and universally accepted biomarkers for systemic treatment are still lacking. Although there are considerable challenges, ongoing research offers hope for future breakthroughs.

Treatment of Intermediate Liver Cancer: Exploring Combination Therapies

Compared to advanced liver cancer, treatment strategies for intermediate liver cancer are more varied and complex. Combination therapy was a hot topic at this year’s ILCA, with promising results from the EMERALD-1 and LEAP-012 studies. Both studies demonstrated that systemic therapy combined with local treatment significantly extended progression-free survival (PFS) compared to local treatment alone. While overall survival (OS) data is pending, the notion that a PFS hazard ratio (HR) close to 0.6 could serve as a reliable surrogate for OS highlights the potential of combination therapy to improve patient outcomes. This finding provides theoretical support for combination therapy and sets a direction for future research.

Treatment of Early-Stage Liver Cancer: Advances in Adjuvant and Neoadjuvant Therapy

Early-stage liver cancer treatment also garnered significant attention. While curative rates and survival times are generally higher for early-stage liver cancer, adjuvant and neoadjuvant therapies remain complex and continue to evolve. A key trial in this area, the IMbrave050 study, investigated adjuvant therapy with atezolizumab and bevacizumab (T+A) for high-risk recurrence after curative surgery or ablation. Initial analysis showed that T+A significantly improved recurrence-free survival (RFS) compared to active surveillance. However, the final RFS data presented at ESMO 2024 did not yield positive long-term results, indicating that positive results in adjuvant therapy are still elusive. Researchers remain committed to gathering further clinical data to validate the effectiveness and safety of these treatment methods.

Keynote Presentations: Future Directions of Liver Cancer Clinical Trials and AI Innovations

The conference also featured two highly anticipated keynote presentations. Prof. Bruno Sangro from the University of Navarra, Spain, delivered an in-depth presentation on clinical trial goals and endpoints in liver cancer, providing valuable theoretical and practical guidance for designing and implementing future trials. Another keynote focused on the latest advances in AI applications in liver cancer diagnosis and treatment. With AI’s powerful data analysis capabilities, it can provide deeper insights into patient conditions and prognoses, offering more personalized treatment options. The use of AI in surgical assistance and treatment decision-making also has the potential to improve treatment outcomes for liver cancer patients.

Outlook: The Future and Challenges of Liver Cancer Research

Reflecting on this conference, we witnessed not only the latest advances and future directions in liver cancer treatment but also the collective dedication to collaboration and innovation among researchers worldwide. Although significant challenges and unresolved questions remain, the future of liver cancer research appears bright through the united efforts of global researchers.

Future liver cancer research will continue to explore new treatment methods and technologies to improve patient cure rates and survival times. Ongoing research into the pathogenesis and biological characteristics of liver cancer will pave the way for more precise and personalized treatments. Strengthening international collaboration and exchange will further advance the global process of liver cancer research, bringing hope and relief to more patients.

Dr. Guohong Han

• Executive Dean of Digestive Disease Hospital, Xi’an International Medical Center
• Expert in liver cancer treatment, including targeted therapy, immunotherapy, and regional therapies
• Lead investigator on multiple clinical studies focused on systemic and combination therapies in advanced liver cancer