Advancement in hepatocellular carcinoma research: Biomarkers, therapeutics approaches and impact of artificial intelligence

Cancer is a leading, highly complex, and deadly disease that has become a major concern in modern medicine. Hepatocellular carcinoma is the most common primary liver cancer and a leading cause of global cancer mortality. Its development is predominantly associated with chronic liver diseases such as hepatitis B and C infections, cirrhosis, alcohol consumption, and non-alcoholic fatty liver disease. Molecular mechanisms underlying HCC involve genetic mutations, epigenetic changes, and disrupted signalling pathways, including Wnt/β-catenin and PI3K/AKT/mTOR. Early diagnosis remains challenging, as most cases are detected at advanced stages, limiting curative treatment options. Diagnostic advancements, including biomarkers like alpha-fetoprotein and cutting-edge imaging techniques such as CT, MRI, and ultrasound-based radiomics, have improved early detection. Treatment strategies depend on the disease stage, ranging from curative options like surgical resection and liver transplantation to palliative therapies, including transarterial chemoembolization, systemic therapies, and immunotherapy. Immune checkpoint inhibitors targeting PD-1/PD-L1 and CTLA-4 have shown promise for advanced HCC. In this review we discuss about emerging technologies, including artificial intelligence and multi-omics platforms for HCC management by enhancing diagnostic accuracy, identifying novel therapeutic targets, and enabling personalized treatments. Despite these advancements, the prognosis for HCC patients remains poor, underscoring the need for continued research into early detection, innovative therapies, and translational applications to effectively address this global health challenge.