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A lot of research is being done on liver cancer. Scientists are looking for the causes of liver cancer, as well as ways to prevent it, find it early, and improve treatments.

Research into liver cancer prevention

Worldwide, the most common risk factor for liver cancer is long-term infection with hepatitis B virus (HBV) or hepatitis C virus (HCV). These infections have made liver cancer the most common cancer in many parts of the world.

Some scientists believe that vaccines and improved treatments for viral hepatitis could prevent about half of liver cancer cases worldwide. Researchers are studying ways to prevent or treat hepatitis infections before they cause liver cancers.

Vaccines to prevent hepatitis B are widely available. And while there’s no vaccine yet to prevent hepatitis C, medicines can now cure this infection in most people.

Screening

At this time, there are no widely recommended screening tests for liver cancer in people who are at average risk, although alpha-fetoprotein (AFP) blood tests and ultrasound exams might be advised in some people at higher risk. (See Can Liver Cancer Be Found Early? )

Several new blood tests are being studied to see if they can detect liver cancer earlier than using AFP and ultrasound.

CT scans and MRI scans are also being studied for use as imaging tests to screen for liver cancer instead of ultrasound.

Research on liver cancer surgery

Newer techniques are being developed to make partial hepatectomy (removal of part of the liver) and liver transplants safer and more helpful.

For example, surgeons in many cancer centers now use minimally invasive surgical techniques to remove parts of the liver. An example is robotic hepatectomy. Instead of operating through a long incision, the surgeon sits at a panel near the operating table and controls robotic arms with long, thin surgical instruments on the ends to operate through several small incisions. The robotic system lets the surgeon move the instruments very precisely.

This type of surgery usually results in a shorter hospital stay and less pain after surgery.

Doctors are also studying if it’s safe to allow more people with liver cancer to be eligible for a liver transplant.

Adding other treatments to surgery

An active area of research is looking at adjuvant treatments (given right after surgery) to try to reduce the chances that the liver cancer will return. Studies are looking into using newer immunotherapy and targeted therapy drugs as possible adjuvant treatments. Some promising results have also been seen with radioembolization, but these need to be confirmed in larger studies.

Another area being studied is the use of anti-viral therapy in people with liver cancer related to hepatitis B or hepatitis C, to see if this improves outcomes after surgery.

Doctors are also studying ways to make more liver cancers removable by shrinking them before surgery. Studies are looking at different types of neoadjuvant treatments (given before surgery), including targeted therapy, immunotherapy, ablation, embolization, and radiation therapy.

Determining recurrence risk after surgery

After a partial hepatectomy, one of the biggest concerns is that the cancer might come back (recur). Knowing someone's risk for recurrence after surgery might give doctors a better idea of how best to follow up with them. This may someday help determine who needs further treatment to lower this risk.

Researchers are studying ways to predict if the cancer will come back by testing the liver cells in the surgery sample through genetic profiling. Studies are being done to confirm if this will be helpful.

Research into ablation therapy for liver cancer

Newer ablation techniques are being studied. For example, irreversible electroporation is an ablation procedure that does not use heat or cold to destroy cancer cells. It uses high voltage to open the "pores" of the cell (like the pores of your skin), which causes the cancer cells to die. It may be very useful for cancers that are in difficult areas to treat, such as near blood vessels.

Research into immunotherapy treatment for liver cancer

Immunotherapy drugs boost the body’s immune system to help fight the cancer. Medicines known as immune checkpoint inhibitors have become an important part of the treatment for people with advanced liver cancer.

Doctors are now testing if these medicines can be helpful for earlier-stage liver cancers, by shrinking liver tumors and making surgery possible in some cases, or in lowering the risk of the liver cancer coming back if these drugs are given after surgery.

Research on targeted therapy for liver cancer

Newer drugs have been developed that work differently from standard chemotherapy drugs. These targeted drugs act on specific proteins in cancer cells or their surrounding environments.

Targeted drugs are becoming a more important part of the treatment for advanced liver cancers. Some of these drugs are now being studied to see if they can be used earlier in the course of the disease, and many newer targeted drugs are being tested as well.

Research on liver cancer biomarkers

Knowing which liver cancers will respond to certain treatments would help save people from side effects of unhelpful drugs. Research is being done to look for specific biomarkers (such as proteins or changes in gene patterns in the cancer cells) to see if this can help guide whether certain targeted drugs or immunotherapy treatments are likely to be helpful.