The liver is located behind the rib cage below the right lung. The largest internal organ in the body, it is pyramid-shaped and has two lobes, which are further subdivided into segments. The liver has many important functions, including processing and storing several nutrients that are later used for energy or to build and repair tissues. It collects and filters blood, makes clotting factors to help stop bleeding, secretes bile into the intestines to assist in nutrient absorption, breaks down and removes toxic waste from the blood, and maintains proper blood sugar levels.
Liver cancer begins when healthy cells mutate and grow uncontrollably. These cells accumulate and form a mass, known as a primary tumor. The most common type of primary liver cancer is hepatocellular carcinoma (HCC).
Tumor analysis has advanced in recent years to identify genes, proteins and biomarkers that may be associated with liver cancer. Your doctor may test for the alpha-fetoprotein (AFP) biomarker. Not all tumors will test positive for a biomarker, but more than half of the people diagnosed with HCC have elevated levels of AFP.
Treatment options for liver cancer are surgery, a liver transplant, ablation therapy, embolization therapy, chemoembolization and radioembolization, targeted therapy, radiation therapy and immunotherapy.
The most common type of primary liver cancer is hepatocellular carcinoma (HCC) (see Gastrointestinal Anatomy). Immune checkpoint inhibitors are the type of immunotherapy currently approved to treat HCC in people who were previously treated with a specific type of targeted therapy. This type of immunotherapy may be used alone or in combination with other therapies. More recently, another immune checkpoint inhibitor in combination with an antiangiogenesis treatment was approved for the treatment of liver cancer as first-line therapy when the PD-L1 expression is high in cancer cells.