# Transforming Liver Cancer Therapy: Integrating Molecular Profiling with Precision and Transplant-Based Care

## TL;DR

This paper reviews how molecular profiling and precision medicine are improving liver cancer treatment and transplant care.

## Contribution

The paper integrates molecular and immunological insights with transplant-based strategies for HCC management.

## Key findings

- Molecular markers like AFP and DCP refine transplant eligibility and post-transplant monitoring.
- Liquid biopsy and multi-omics approaches detect residual disease and recurrence earlier.
- Immune modulation and mTOR-based suppression guide personalized immunotherapy use.

## Abstract

Molecular and immunological profiling are transforming how hepatocellular carcinoma (HCC) is managed. Integrating biomarkers such as AFP, DCP, radiomics, and circulating tumour DNA refines transplant eligibility and post-transplant surveillance. Advances in understanding the tumour microenvironment and immune modulation guide the rational use of immunotherapy and mTOR-based immunosuppression. Liquid biopsy and multi-omics approaches enable earlier detection of molecular residual disease and tumour recurrence after curative treatment. Together, these developments support a precision-oriented, transplant-aware framework that bridges molecular discovery with clinical decision-making in everyday HCC care.

Liver cancer, predominantly hepatocellular carcinoma (HCC), remains a leading cause of cancer-related mortality worldwide. Although systemic therapies have advanced in recent years, overall survival remains limited for many patients. A deeper understanding of the molecular and immunological landscape of HCC has driven the emergence of new therapeutic paradigms, from molecularly targeted agents to immune checkpoint blockade. Concurrently, innovations in liver transplantation, liquid biopsy, and multi-omics profiling are reshaping the therapeutic algorithm for selected candidates. This review summarises recent progress in molecular classification, tumour microenvironment mapping, and immune modulation, and examines how these translational insights are redefining clinical practice. Particular emphasis is placed on the integration of molecular markers into transplant eligibility, downstaging strategies, and post-transplant immunosuppression, providing a comprehensive, precision-oriented framework that bridges basic discovery and patient-centred care.