AI Liver Cancer Strategy Navigator™

The BCLC (Barcelona Clinic Liver Cancer) system is the most widely used classification system for liver cancer, dividing patients into 5 stages (0, A, B, C, D) based on tumor size, number of tumors, liver function (Child-Pugh), and performance status (ECOG). Each stage has different treatment options. The latest BCLC 2025 version added the CUSE Framework and ALBI Grade for precise personalization.

Western guidelines (EASL/NCCN/BCLC) tend toward systemic therapy (Atezolizumab+Bevacizumab) for advanced cases. Asian guidelines (CNLC) favor a more interventional approach including Conversion Therapy (targeted therapy + immunotherapy + TACE/HAIC) to transform unresectable tumors into resectable ones. China conducts the largest number of clinical trials for cellular therapies (CAR-T, TCR-T).

HAIC (Hepatic Arterial Infusion Chemotherapy) is continuous chemotherapy infusion through the hepatic artery over hours or days. TACE is chemotherapy injection + arterial embolization. HAIC is used more in Asia for PVTT (portal vein tumor thrombus) and high tumor burden. Chinese protocols combining HAIC + Lenvatinib + PD-1 achieve response rates of 60-70%.

Milan Criteria: (1) single tumor ≤5 cm, or (2) up to 3 tumors each ≤3 cm, (3) no extrahepatic spread, (4) no vascular invasion. Patients within these criteria have 5-year survival of 70-80% after transplant. Patients Beyond Milan can achieve downstaging with therapy and then transplant.

Yes. Even BCLC C (advanced) has options: Atezolizumab+Bevacizumab (median survival 19.2 months), Durvalumab+Tremelimumab, Lenvatinib. In Asia: Conversion Therapy can convert 50% of advanced cases to resectable. Clinical trials (CAR-T, TCR-T) offer hope for resistant cases.

Immunotherapy (Atezolizumab+Bevacizumab) is the global first-line standard for advanced HCC (BCLC C). It achieves 30% response rate and median survival of 19.2 months. Durvalumab+Tremelimumab (dual immunotherapy) is an additional option. Immunotherapy is also used in Asian combination protocols (immunotherapy + targeted + TACE/HAIC).

Conversion Therapy is a treatment strategy aiming to shrink unresectable tumors to become surgically resectable. The typical Chinese protocol: Targeted Therapy (Lenvatinib) + Immunotherapy (PD-1) + TACE or HAIC. Success rate reaches 50% conversion to radical surgery, with long-term survival.