Disparities in access to systemic therapies for patients with hepatocellular carcinoma: an analysis from the International Liver Cancer Association

Abstract

Hepatocellular carcinoma (HCC) is a major cause of cancer deaths worldwide. It is often diagnosed at advanced stages, requiring systemic therapies like sorafenib, lenvatinib, atezolizumab-bevacizumab, and tremelimumab-durvalumab. However, disparities in access to systemic therapies for HCC remain a major global challenge, particularly in low- and middle-income countries where high drug costs, regulatory delays, and limited healthcare infrastructure impede treatment. Drawing on international experience, we highlight the urgent need for coordinated advocacy and innovative programs—such as Project Orbis and expedited approval pathways—to improve drug availability. Multisectoral collaboration among patient groups, clinicians, policymakers, and industry is essential to ensure equitable access to life-saving therapies and to reduce the burden of HCC worldwide.