Considerations for individualized first-line systemic treatment in advanced hepatocellular carcinoma

Primary liver cancer is the third most common cause of cancer -related death worldwide and hepatocellular carcinoma (HCC) accounts for approximately 80%-90% of all primary liver ma-lignancies. Until 2007, there was no effective treatment option available for patients diagnosed with advanced HCC, whereas today, both multireceptor tyrosine kinase inhibitors as well as immunotherapy combinations have entered clinical practice. The choice between the different options is a tailor-made de-cision to match the efficacy and safety data of the clinical trials with the specific patient and disease profile. This review pro-vides clinical stepstones to make an individualized decision for every patient with its specific tumor and liver characteristics in mind.