Several notable new liver cancer (HCC) treatments and approvals emerged in 2024–2025:

1. Durvalumab + Tremelimumab (Imfinzi + Imjudo) expanded use

This dual-immunotherapy regimen continued gaining regulatory expansion as a frontline option for unresectable HCC, showing durable survival benefits.

2. Donafenib (new-generation TKI)

Approved in China and entering broader global use; better tolerability than sorafenib with non-inferior survival.

3. Camrelizumab + Rivoceranib

An immunotherapy + TKI combination adopted in more regions after strong OS benefit data—now considered a leading frontline regimen.

4. Novel locoregional + immunotherapy combinations

2025 saw strong Phase III results for:

• TACE + PD-1 inhibitors

• Y-90 radioembolization + immunotherapy
  These combinations are moving toward guideline inclusion.

5. Early breakthroughs

• Oncolytic virus therapies for HCC are showing promising early-phase data.

• mRNA and peptide-based cancer vaccines (neoantigen-targeting) in mid-2025 trials.

• FGF19/FGFR4 inhibitors for biomarker-selected patients.

Liver cancer (mainly hepatocellular carcinoma, HCC) can grow very quickly, but the speed varies depending on the tumor biology and liver condition.

Typical growth rate

• Many HCC tumors double in size every 3–6 months.

• More aggressive tumors can double in 1–2 months.

• Slow-growing tumors may take 6–12+ months to double.

What affects how fast it grows?

• Underlying liver disease (cirrhosis often slows growth because the liver is stiff and scarred)

• Tumor subtype (some HCC variants are more aggressive)

• AFP levels (high AFP can indicate faster growth)

• Genetic mutations in the tumor

• Presence of vascular invasion (tumor entering blood vessels usually means faster spread)

Key takeaway

Most liver cancers grow faster than many other solid tumors, which is why regular imaging and early treatment are crucial.

Top 6 Liver Cancer Centers in the United States

1. MD Anderson Cancer Center (Houston, TX)

• Consistently #1 in U.S. for liver and GI cancers

• Extremely strong interventional radiology, immunotherapy trials, and advanced surgical options

2. Mayo Clinic (Rochester, MN; Phoenix, AZ; Jacksonville, FL)

• World-class liver transplant program

• Excellent outcomes for early and advanced HCC

3. UCLA Health / Jonsson Comprehensive Cancer Center

• Leading center for locoregional therapies (TACE, Y-90)

• Large pipeline of clinical trials and transplant expertise

4. Cleveland Clinic

• High-volume liver surgery and transplant center

• Strong outcomes for complex cases

5. Memorial Sloan Kettering (New York, NY)

• Known for precision oncology, trials, and interventional approaches

• Exceptional hepatobiliary surgeons

6. UCSF Helen Diller Family Comprehensive Cancer Center

• One of the best liver-transplant oncology programs in the world

• Pioneers of transplant criteria for HCC

Major Types of Liver Cancer Clinical Trials Available Now

1. Immunotherapy Trials

• PD-1/PD-L1 inhibitors (e.g., nivolumab, pembrolizumab, durvalumab)

• Combination immunotherapy (e.g., anti-PD-1 + anti-CTLA-4)

• Novel checkpoint inhibitors (LAG-3, TIGIT, TIM-3)

• Cell therapies (TCR therapies and early-stage CAR-T for HCC)

2. Targeted Therapy Trials

• Next-generation TKIs (beyond sorafenib/lenvatinib)

• Trials combining TKIs + immunotherapy

• Agents targeting FGF19/FGFR4, VEGF, MET, RAS/RAF, Wnt/β-catenin pathways

3. Locoregional Therapy + Drug Combinations

• TACE + immunotherapy

• Y-90 radioembolization + systemic therapy

• Ablation therapies + checkpoint inhibitors

4. Gene-based and Experimental Modalities

• Oncolytic viruses

• RNA-based therapeutics

• Personalized vaccine trials for HCC neoantigens

5. Trials for Specific Populations

• Child-Pugh B trials

• Trials for previously treated vs. treatment-naive patients

• Trials for patients with portal vein thrombosis

The last stage of liver cancer is Stage IV (Stage 4). This is the most advanced stage and generally means one or both of the following:

Stage IV liver cancer

• The cancer has spread (metastasized) outside the liver
  — commonly to lungs, bones, or distant lymph nodes

• The tumor burden within the liver is extensive, often with vascular invasion (such as the portal vein or hepatic veins)

Depending on the staging system used (AJCC vs. BCLC), Stage IV corresponds to:

AJCC Stage IV

• IVA: Spread to nearby lymph nodes

• IVB: Spread to distant organs (lung, bones, etc.)

BCLC “Terminal Stage” (Stage D)

Clinically, many doctors refer to the BCLC system, where the final stage is:

• BCLC Stage D → very poor liver function + advanced cancer + limited treatment options

What it means for patients

• Curative treatments (surgery, transplant, ablation) are no longer possible

• Treatment focuses on slowing cancer, managing symptoms, and preserving quality of life

• Options may include immunotherapy, targeted therapy, clinical trials, or supportive care depending on liver function (Child-Pugh).

Liver cancer (mainly hepatocellular carcinoma, HCC) happens when long-term injury to the liver causes chronic inflammation, scarring, and DNA damage that eventually leads to malignant cell growth.
The major causes are well known:

1. Chronic viral hepatitis (biggest global cause)

• Hepatitis B

• Hepatitis C
  These viruses cause ongoing liver inflammation that drives cancer over years or decades.

2. Cirrhosis (scarring of the liver)

Cirrhosis from any cause is a major driver of liver cancer.
Leading contributors include:

• Viral hepatitis

• Heavy alcohol use

• Nonalcoholic fatty liver disease (NAFLD/NASH)

• Autoimmune liver diseases

3. Alcohol-related liver disease

Years of heavy drinking → chronic damage → cirrhosis → higher cancer risk.

4. Metabolic disease (rapidly rising cause in the U.S.)

• NAFLD/NASH linked to obesity, diabetes, and metabolic syndrome
  This is now one of the fastest-growing causes of liver cancer in Western countries.

5. Environmental / toxin exposure

• Aflatoxin (mold-contaminated grains, common in parts of Africa/Asia)

• Some industrial chemicals (rare)

6. Genetic conditions (less common)

• Hemochromatosis

• Wilson’s disease

• Alpha-1 antitrypsin deficiency