Background/Objectives: Hepatocellular carcinoma (HCC), the predominant form of liver cancer, ranks as the third leading cause of cancer-related deaths worldwide. With the shift from viral hepatitis to metabolically dysfunction-associated steatosis liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) as primary etiologies, we aimed to review ongoing clinical trials in adult HCC patients to highlight emerging treatments, particularly for nonviral HCC cases. Methods: We searched ClinicalTrial.gov (last March 2025) for interventional trials. We included ongoing (recruiting/active/not recruiting), phase I-IV, adults (>18 years old), and HCC-focused only clinical trials. We excluded observational and interventional (biological, genetic, device, or procedure) clinical trials. Results: This review highlights recent advances in HCC treatment, with a focus on the transformative role of immunotherapy. Evidence suggests that nonviral HCC, as well as HCC with MASLD/MASH background livers, may have reduced sensitivity to immunotherapy. Thus, there is a critical need for molecular insights to improve patient stratification. Moreover, we examine how new diagnostic tools, including liquid biopsies, influence treatment decisions and aid in monitoring responses. Limitations limited MASLD/MASH-specific trial data. Conclusions: We review current research and its integration into clinical practice, advancing HCC therapy toward personalized, patient-centered care.
背景/目的：肝细胞癌（HCC）作为肝癌的主要类型，是全球癌症相关死亡的第三大原因。随着主要病因从病毒性肝炎转向代谢功能障碍相关脂肪性肝病（MASLD）和代谢功能障碍相关脂肪性肝炎（MASH），本研究旨在综述成人HCC患者的在研临床试验，以突出新兴治疗方法，特别是针对非病毒性HCC病例。方法：我们在ClinicalTrial.gov（截至2025年3月）检索了干预性试验。纳入标准为：正在进行中（招募中/活跃/未招募）、I-IV期、仅针对成人（>18岁）且聚焦HCC的临床试验。排除了观察性及干预性（生物、遗传、器械或手术）临床试验。结果：本综述重点阐述了HCC治疗的最新进展，特别关注免疫疗法的变革性作用。有证据表明，非病毒性HCC以及具有MASLD/MASH背景肝脏的HCC可能对免疫疗法的敏感性降低。因此，亟需通过分子层面的深入理解来优化患者分层。此外，我们还探讨了包括液体活检在内的新型诊断工具如何影响治疗决策并辅助监测疗效。局限性：目前缺乏针对MASLD/MASH的特异性试验数据。结论：我们综述了当前研究及其与临床实践的整合，推动HCC治疗向个性化、以患者为中心的精准医疗方向发展。
肿瘤(癌症)患者之家