BEACON-HCC: Moving HCC Treatment Beyond Stage-Based Allocation: Hepatology | August 2026

Introduction:

HCC treatment has traditionally been closely linked to staging systems such as BCLC. However, modern multidisciplinary care increasingly includes TARE, external-beam radiotherapy, systemic therapy, and combined approaches that do not always fit stage-based algorithms. BEACON-HCC proposes a more individualized treatment-allocation framework.

Why was this consensus needed?

HCC stage alone may not capture the full therapeutic potential of an individual patient.

Modern locoregional and systemic therapies have expanded treatment options.

Vascular invasion and intrahepatic tumour burden vary substantially within the same stage.

Multidisciplinary practice increasingly extends beyond traditional stage-linked recommendations.

Key Takeaways:

BEACON-HCC was developed by a 20-member North American multidisciplinary expert panel.

Treatment allocation incorporates tumour number, size, and overall intrahepatic burden.

The framework separately considers the extent of vascular invasion and extrahepatic spread.

Liver function and adverse tumour biology are integrated into treatment selection.

Unlike conventional algorithms, BEACON-HCC explicitly incorporates external-beam radiotherapy and TARE.

It also accommodates systemic–locoregional combination strategies.

The framework allows selected patients traditionally labelled as advanced disease to remain candidates for aggressive locoregional or potentially curative-intent treatment.

In a 29-case pilot, expert treatment choices matched BEACON-HCC in 96.6% of cases vs 72.4% with BCLC 2025.

BEACON-HCC is an expert-consensus framework—not an AASLD guideline or prospectively validated staging system.

Prospective validation is required before it can replace established treatment-allocation systems.

What’s New?

BEACON-HCC shifts the central question from “What treatment belongs to this stage?” to “What treatments remain realistically available for this patient?”—bringing treatment allocation closer to contemporary multidisciplinary HCC practice.

Bottom Line:

BEACON-HCC challenges rigid stage-based treatment allocation by integrating tumour biology, liver function, and modern multimodal therapies. It is a promising framework, but prospective validation is needed before replacing established systems such as BCLC.