New Liver Cancer BEACON-HCC Framework Shows 96.6% Concordance in Pilot

A new consensus framework for treating hepatocellular carcinoma (HCC) outperformed the current staging system in a pilot study. BEACON-HCC matched independent expert treatment decisions 96.6% of the time, compared with 72.4% for the Barcelona Clinic Liver Cancer (BCLC) 2025 system. The framework was published by the American Association for the Study of Liver Diseases (AASLD) in HEPATOLOGY.

Framework Developed to Reflect Expanding HCC Treatment Landscape

BEACON-HCC was developed by 20 North American experts spanning hepatology, medical oncology, surgery, radiology, and radiation oncology. The consensus was created using a modified Delphi process and is intended to update treatment allocation approaches for HCC, which investigators note have not kept pace with the growing number of available therapies.

HCC remains the third leading cause of cancer-related death worldwide and the leading cause of cancer-related mortality among patients with cirrhosis. Five-year survival remains below 25%, a statistic the framework's developers cite as justification for a more contemporary approach to treatment planning.

“HCC treatment has evolved dramatically over the past decade, yet many existing treatment frameworks have not fully incorporated these advances,” said Amit G. Singal, MD, MS, FAASLD, of University of Texas Southwestern, in a statement. “BEACON-HCC reflects how multidisciplinary experts evaluate patients today by integrating the latest evidence with real-world clinical expertise to support more personalized treatment decisions.”

What Sets BEACON-HCC Apart From Existing Staging Systems

Rather than relying solely on liver function and disease stage, BEACON-HCC incorporates tumor biology, overall disease burden, and extent of vascular invasion into its recommendations. The framework also accounts for a broader set of contemporary treatment modalities, including external beam radiation therapy (EBRT), transarterial radioembolization (TARE), and combined systemic-locoregional strategies.

“The treatment landscape for liver cancer is changing rapidly,” said Mark Yarchoan, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medicine, in a statement. “This framework provides clinicians with a contemporary roadmap that better reflects current evidence, multidisciplinary expertise, and the expanding therapeutic options available to patients.”

The concordance figures cited above come from a pilot study of 29 real-world patient cases, in which independent multidisciplinary experts not involved in developing BEACON-HCC reviewed cases and made treatment recommendations.

Those decisions were then compared against both the BEACON-HCC framework and BCLC 2025 recommendations to calculate concordance. Given the small sample size, the authors describe the pilot as an initial validation step rather than definitive evidence.

Clinical Implications and Next Steps for Validation

The authors describe BEACON-HCC as a complement to, rather than a replacement for, multidisciplinary clinical decision-making, and note that it will continue to be refined as new evidence emerges. Further validation is planned through the HCC-Live Consortium using prospective clinical data.

The publication is being positioned as one of the more comprehensive multidisciplinary efforts to redefine HCC treatment allocation in North America to date.

References

1. Singal AG, Yarchoan M, et al. BEACON-HCC: Best Evidence and North American Consensus on Hepatocellular Carcinoma. Hepatology. Published online August 5, 2026. doi:10.1097/HEP.0000000000001834

2. American Association for the Study of Liver Diseases. HEPATOLOGY publishes landmark North American framework to advance treatment decisions for liver cancer. Press release. August 7, 2026. Accessed August 7, 2026. https://www.aasld.org/hepatology-publishes-landmark-north-american-framework-advance-treatment-decisions-liver-cancer