The last 5 years have witnessed relevant advances in the systemic treatment of hepatocellular carcinoma. New data have emerged since the development of the EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma in 2018. Drugs licensed in some countries now include 4 oral multi-tyrosine kinase inhibitors (sorafenib, lenvatinib, regorafenib and cabozantinib), 1 anti-angiogenic antibody (ramucirumab) and 4 immune checkpoint inhibitors, alone or in combination (atezolizumab in combination with bevacizumab, ipilimumab in combination with nivolumab, nivolumab and pembrolizumab in monotherapy). Prolonged survival in excess of 2 years can be expected in most patients with sensitive tumours and well-preserved liver function that renders them fit for sequential therapies. With different choices available in any given setting, the robustness of the evidence of efficacy and a correct matching of the safety profile of a given agent with patient characteristics and preferences are key in making sound therapeutic decisions. The recommendations in this document amend the previous EASL Clinical Practice Guidelines and aim to help clinicians provide the best possible care for patients today. In view of several ongoing and promising trials, further advances in systemic therapy of hepatocellular carcinoma are foreseen in the near future and these recommendations will have to be updated regularly.

过去 5 年见证了肝细胞癌全身治疗的相关进展。自 2018 年制定关于肝细胞癌管理的 EASL 临床实践指南以来，出现了新的数据。目前在一些国家获得许可的药物包括 4 种口服多酪氨酸激酶抑制剂（索拉非尼、乐伐替尼、瑞戈非尼和卡博替尼）、1 种抗血管生成药抗体（ramucirumab）和 4 种免疫检查点抑制剂，单独或联合使用（atezolizumab 联合贝伐单抗，ipilimumab 联合 nivolumab，nivolumab 和 pembrolizumab 单药治疗）。大多数患有敏感肿瘤和保存良好的肝功能的患者可以预期超过 2 年的延长生存期，这使他们适合序贯治疗。在任何给定的环境中都有不同的选择，疗效证据的稳健性以及给定药物的安全性与患者特征和偏好的正确匹配是做出合理治疗决策的关键。本文件中的建议修订了之前的 EASL 临床实践指南，旨在帮助临床医生为当今的患者提供尽可能好的护理。鉴于几项正在进行的和有希望的试验，预计在不久的将来肝细胞癌的全身治疗将取得进一步进展，这些建议将必须定期更新。本文件中的建议修订了之前的 EASL 临床实践指南，旨在帮助临床医生为当今的患者提供尽可能好的护理。鉴于几项正在进行的和有希望的试验，预计在不久的将来肝细胞癌的全身治疗将取得进一步进展，这些建议将必须定期更新。本文件中的建议修订了之前的 EASL 临床实践指南，旨在帮助临床医生为当今的患者提供尽可能好的护理。鉴于几项正在进行的和有希望的试验，预计在不久的将来肝细胞癌的全身治疗将取得进一步进展，这些建议将必须定期更新。