Hepatocarcinoma: From Risk Factors to Immunotherapy. The Role of Awareness and Early Detection: A Narrative Review

Europäische Wissenschaftliche Gesellschaft Home About the Journal Peer Review Editorial Board For Authors Reviewer Recognition Archive Contact Impressum EWG e.V. Elektronische Zeitschriftbibliotek Logo Bielefeld Academic Search Engine Logo Erfolgreich durch internationale Zusammenarbeit ONCOLOGY Cite as: Archiv EuroMedica. 2025. 15; 4. DOI 10.35630/2025/15/4.006 Received 17 June 2025; Accepted 16 August 2025; Published 21 August 2025 Hepatocarcinoma: From Risk Factors to Immunotherapy. The Role of Awareness and Early Detection: A Narrative Review Paulina Redel1 email orcid id logo, Aleksandra Dzwonkowska2 orcid id logo 1 The University Hospital in Kraków, Poland 2 Praski Hospital of the Transfiguration of the Lord, Warsaw, Poland download article (pdf) redelpaulina@gmail.com ABSTRACT Background: Hepatocellular carcinoma (HCC) is one of the most common and deadly liver malignancies worldwide. Its rising incidence is linked not only to viral hepatitis and cirrhosis, but increasingly to metabolic disorders such as obesity, type 2 diabetes, and non-alcoholic fatty liver disease. Most cases are diagnosed at advanced stages, when curative treatment options are limited. In recent years, immunotherapy has emerged as a promising systemic strategy. Objective: This narrative review aims to summarize current knowledge on the pathogenesis, risk factors, diagnostic approaches, and especially immunotherapeutic strategies for HCC, with a focus on immune checkpoint inhibitors and their clinical relevance. Methods: A non-systematic narrative review was conducted using PubMed and Google Scholar. The search included English-language publications from January 2015 to March 2024. Search terms included combinations of "hepatocellular carcinoma," "HCC," "immune checkpoint inhibitors," "PD-1," "PD-L1," "CTLA-4," and "tyrosine kinase inhibitors." Preference was given to peer-reviewed research articles, clinical guidelines, and high-quality reviews. Results: Immunotherapy, particularly the use of immune checkpoint inhibitors such as nivolumab, pembrolizumab, and the combination of atezolizumab with bevacizumab, has shown clinical benefits in patients with advanced HCC. These agents enhance antitumor immune responses by targeting inhibitory pathways such as PD-1/PD-L1 and CTLA-4. Despite these advances, treatment response rates remain limited, and most patients experience disease progression. The immunosuppressive tumor microenvironment and lack of predictive biomarkers present major therapeutic challenges.