Treatments for stage C liver cancer

Last medical review: September 2019

The following are treatment options for stage C liver cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Targeted therapy

Targeted therapy is the standard treatment for stage C liver cancer. It uses drugs to treat specific molecules (such as proteins) on cancer cells or inside them. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. The targeted therapy drugs used for stage C liver cancer are:

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

Immunotherapy

Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer. You may be offered immunotherapy for stage C liver cancer.

Pembrolizumab (Keytruda) may be offered if you have already had treatment with sorafenib or are unable to take sorafenib or other treatments.

Atezolizumab (Tecentriq, Tecentriq SQ) with bevacizumab (Avastin), tremelimumab (Imjudo) with durvalumab (Imfinzi) or durvalumab on its own may be offered if you cannot have surgery and have not yet had treatment.

Radiation therapy

If you are not well enough to have targeted therapy or immunotherapy, you may be offered external radiation therapy. This treatment can help relieve pain caused by advanced liver cancer (called palliative treatment), such as when cancer spreads to the bones.

Clinical trials

Talk to your doctor about clinical trials open to people with liver cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Kelly W Burak, MD, FRCPC, MSc(Epid)
Vincent Tam, BSc(Hon), MD, FRCPC

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.
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.

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