Targeted therapy for liver cancer

Last medical review:

Most people with liver cancer may eventually need to have targeted therapy. It uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells. They may also block tumours from developing new blood vessels. Targeted therapy may also be called molecular targeted therapy.

You may have targeted therapy if you have advanced liver cancer and:

  • you can’t have surgery or ablation therapy
  • the cancer no longer responds to other treatments, such as transarterial chemoembolization (TACE)
  • your liver is still working well and have a Child-Pugh score of A or, in rare cases, B

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.

Targeted therapy drugs used for liver cancer

Targeted therapy drugs used are:

  • sorafenib (Nexavar)
  • lenvatinib (Lenvima)
  • regorafenib (Stivarga)
  • cabozantinib (Cabometyx)

Side effects

Side effects can happen with any type of treatment for liver cancer, but everyone's experience is different. Some people have many side effects. Other people have only a few side effects.

Targeted therapy attacks cancer cells but doesn't usually damage healthy cells, so there are usually fewer and less severe side effects than with chemotherapy or radiation therapy. Chemotherapy and radiation therapy can damage healthy cells along with cancer cells.

If you develop side effects, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of targeted therapy will depend mainly on the type of drug and your overall health. Some common side effects of targeted therapy for liver cancer are:

Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Information about specific cancer drugs

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Questions to ask about targeted therapy

Find out more about targeted therapy. To make the decisions that are right for you, ask your healthcare team questions about targeted therapy.

Expert review and references

  • Kelly W Burak, MD, FRCPC, MSc(Epid)
  • Vincent Tam, BSc(Hon), MD, FRCPC
  • American Cancer Society. Targeted Therapy for Liver Cancer. 2020. https://www.cancer.org/.
  • Burak KW, Sherman M. Hepatocellular carcinoma: consensus, controversies and future directions: a report from the Canadian Association for the Study of the Liver hepatocellular carcinoma meeting. Canadian Journal of Gastroenterology and Hepatology. 2015: 29(4):178–184. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444026/.
  • European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. Journal of Hepatology. 2018: 69:182–236. https://www.journal-of-hepatology.eu/article/S0168-8278(18)30215-0/fulltext.
  • Fong Y, Dupuy DE, Feng M, Abou-Alfa G. Cancer of the liver. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds.. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer; 2019: 57:844–865.
  • Heimback JK, Kulik LM, Finn RS, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2017: 67(1):358–380.
  • Marrero JA, Kulik LM, Sirlin CB, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018: 68(2):723–750.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers (Version 3.2021). 2021.
  • PDQ® Adult Treatment Editorial Board. Adult Primary Liver Cancer Treatment (PDQ­®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2019. https://www.cancer.gov/.
  • PDQ® Adult Treatment Editorial Board. Adult Primary Liver Cancer Treatment (PDQ®) – Patient Version. Bethesda, MD: National Cancer Institute; 2019. https://www.cancer.gov/.

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