Precision medicine approaches for treating hepatocellular carcinoma

Hepatocellular carcinoma (HCC) accounts for the majority of liver cancer diagnoses and deaths. Risk factors for HCC include viral infections, such as hepatitis B and C, heavy alcohol use, lifestyle choices, and certain inherited genetic disorders. The complex interheterogeneity and intraheterogeneity of HCC tumors requires a more individualized treatment approach. Precision medicine uses next-generation sequencing (NGS) to map a tumor’s genome to identify molecular alterations that are targetable by small molecules and immunotherapies. Although the most common oncogenic drivers of HCC are currently nonactionable, precision medicine technology has been utilized to identify biomarkers capable of predicting treatment response or primary resistance to guide clinical decision-making. This chapter will discuss the current advancements and challenges of precision medicine in HCC.