Hepatocellular carcinoma (HCC) is a frequent and increasing cause of cancerrelated deaths worldwide. Reversing this trend is complicated by the varied aetiological factors leading to liver cirrhosis resulting in molecular genetic and clinical heterogeneity, combined with frequent presentation at advanced stage. Large-scale genomic studies have identified alterations in key signalling pathways for HCC development and progression, but these findings have not yet directly influenced patient management in the clinical setting. Despite these translational challenges, a small number of anti-angiogenic systemic therapy agents have succeeded in recent randomized trials enriching the repertoire of available treatments for advanced HCC. In addition, the early promise of immune checkpoint inhibition is now on the cusp of delivering changes to standard systemic therapy algorithms. This review focuses on recent translational and clinical developments that have advanced current practice and explores the challenges encountered in attempting to improve the outcomes and experience of patients diagnosed with advanced HCC.

肝细胞癌（HCC）是世界范围内与癌症相关的死亡的常见原因，并且在不断增加。导致肝硬化的多种病原学因素导致分子遗传和临床异质性加之晚期频繁出现，扭转这一趋势变得复杂。大规模的基因组研究已经确定了HCC发生和发展的关键信号通路的改变，但是这些发现还没有直接影响临床环境中的患者管理。尽管存在这些翻译难题，但在最近的随机试验中，少数抗血管生成全身性治疗药物已取得成功，从而丰富了晚期HCC可用治疗的范围。此外，免疫检查点抑制的早期希望现在就到了向标准全身治疗算法传递变化的时刻。这篇综述着重于近期翻译和临床发展方面的进展？当前的实践并探讨了在尝试改善诊断为晚期HCC的患者的结局和经验方面遇到的挑战。