HCC pathogenesis in NASH and impact of Fibrosis

Systemic effects of obesity on cancer development are especially relevant to the liver and involve inflammation, genetics, growth factors, adipokines and microbiomes among others. NASH's immune milieu is distinct and diminishes responses to checkpoint inhibitors. Mechanisms linking fibrosis to hepatocellular carcinoma in NASH include actions of hepatic stellate cells as well as the extracellular matrix; stiffness, for example. As effective NASH therapies and antifibrotic treatments emerge, we should explore their impact on hepatocellular carcinoma mechanisms.