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South America Liver Cancer Treatment Market Trends and Insights

Expansion of Immuno-Oncology Regimens and Locoregional Therapy Use

Immunotherapy replaced sorafenib as the primary first-line treatment for hepatocellular carcinoma at better-resourced centers in the South American liver cancer treatment market. A 2025 Brazilian multicenter cohort across 14 centers in 11 states found that atezolizumab plus bevacizumab accounted for 77.9% of first-line regimens. Median overall survival was 14.7 months and reached 20.6 months among patients with Child-Pugh A liver function. A Latin American study across Argentina, Brazil, Chile, and Colombia reported a median overall survival of 17.0 months for atezolizumab plus bevacizumab in routine care.^{[1]Henrique Marques et al., “Effectiveness and Safety of Immunotherapy for Hepatocellular Carcinoma in Clinical Practice,” JCO Global Oncology, ascopubs.org}

Locoregional treatment also evolved as providers increasingly combined transarterial chemoembolization (TACE) with systemic therapies. A 2025 review of randomized studies found that TACE plus immunotherapy reduced the risk of disease progression or death by 37% and improved the objective response rate by 53%. EMERALD-1 reported median progression-free survival of 15.0 months with durvalumab and bevacizumab plus TACE, compared with 8.2 months with TACE alone.^{[2]María Margarita Anders et al., “Latin American Expert Opinion Letter on the Feasibility of Systemic Therapies in Combination with Locoregional Therapies for Hepatocellular Carcinoma,” Annals of Hepatology, alehlatam.org} Real Hospital 笔辞谤迟耻驳耻ê蝉 in Recife introduced a Y-90 dosimetry platform in June 2025 and treated 11 patients with liver cancer, including hepatocellular carcinoma and cholangiocarcinoma. However, the 48% serious adverse-event rate in EMERALD-1 highlighted the need for experienced multidisciplinary teams.

Rising Hepatitis-Associated Liver Cancer Burden

Viral hepatitis remained a major driver of treatment demand in the South America liver cancer treatment market. Hepatitis B accounted for 38% of hepatocellular carcinoma cases in Brazil and 34% in Peru. The Amazon Basin represented 30% of South America’s estimated 4 million hepatitis B carriers, while some Indigenous communities reported seroprevalence above 9.4%. Brazil’s disease burden model projected that hepatitis C-related hepatocellular carcinoma and decompensated cirrhosis would peak between 2028 and 2032, increasing the need for surveillance, early diagnosis, and timely referral.

Brazil’s Ministry of Health reported in July 2026 that viral hepatitis remained a public health priority. Patients without antiviral management often presented with advanced disease, including macrovascular invasion or extrahepatic spread, making systemic therapy the only practical treatment option.^{[3]Instituto Nacional de C?ncer, “Hepatoblastoma,” Ministério da Saúde, gov.br} This pattern was particularly significant in Peru and Bolivia, where hepatitis B-endemic communities had limited access to ultrasound or alpha-fetoprotein surveillance. Late presentation restricted curative treatment options and increased reliance on high-cost systemic regimens.

Broader Availability of Biomarker-Driven Treatments

Biomarker-guided treatment expanded opportunities in the South America liver cancer treatment market beyond hepatocellular carcinoma to cholangiocarcinoma. IDH1 mutations and FGFR2 fusions served as actionable targets, and private oncology networks in Brazil and Argentina increasingly matched eligible patients with approved therapies. ANVISA approved pembrolizumab with gemcitabine and cisplatin for locally advanced or metastatic biliary tract cancer in September 2025. The KEYNOTE-966 findings showed a 17% reduction in mortality risk and median overall survival of 12.7 months, compared with 10.9 months with chemotherapy alone. This represented Keytruda’s 39th approval in Brazil.

Brazil’s accelerated oncology review framework under RDC 1.001/2025 supported faster reviews for serious or debilitating conditions, reducing the time between global launches and regulatory approvals. Argentina approved subcutaneous nivolumab in February 2026, following the approval of subcutaneous atezolizumab in December 2024. Subcutaneous administration took less than 5 minutes, compared with 30-60 minutes for intravenous infusions, improving throughput at oncology day units. The LIVER-R observational study at Oncoclínicas sites also generated prospective evidence on durvalumab-based treatment for hepatobiliary cancers.

Multidisciplinary Care and Real-World Evidence in Reimbursement

Multidisciplinary liver tumor boards supported the safe adoption of treatment combinations in the South America liver cancer treatment market. Their role was critical when care involved interventional radiology, systemic therapy, transplant assessment, and management of treatment-related adverse events. Latin American expert opinion on systemic and locoregional combinations emphasized that clinical feasibility depended on resource availability and healthcare access. Real-world studies from Brazil and the wider region helped clinical societies and payers evaluate treatment outcomes and supported future public reimbursement decisions.

High Cost of Combination Immunotherapies and Fragmented Access

High first-line combination immunotherapy costs restrict access in the South American liver cancer treatment market. Approximately 75% of Brazilians rely on the public healthcare system, which also serves large patient populations in Colombia, Peru, and Chile. An ISPOR Europe 2025 analysis reported total care costs of BRL 498,183,754 (USD 965,865,70.95) for 945 incident hepatocellular carcinoma patients receiving atezolizumab plus bevacizumab in Brazil’s private healthcare system, with drug acquisition representing the primary cost component. Budget constraints often limit public formularies to sorafenib or lenvatinib monotherapy, restricting access to regimens associated with improved survival outcomes. The gap between public and private care also limits the relevance of available clinical evidence for public-sector decision-makers. Private-sector studies typically include patients with Child-Pugh A liver function and good performance status, whereas public-system patients often present with more advanced liver dysfunction. 

Unequal Interventional Oncology Infrastructure and Delayed Diagnosis

TACE, Y-90 radioembolization, and hepatic ablation services remain concentrated in major cities, including S?o Paulo, Rio de Janeiro, Buenos Aires, Bogotá, and Santiago. Patients across Peru, Bolivia, Ecuador, Paraguay, and northern Brazil have limited access to these treatments. Latin American expert opinion indicated that resource and access barriers restrict the practical use of systemic and locoregional combinations despite Phase III evidence. Patients may reach specialist care only after progression to the BCLC-C stage, shifting treatment toward systemic therapy and resulting in poorer outcomes. Infrastructure investment is progressing, but operational capacity will require time to develop. The original research identified planned oncology expansion in Peru and other underserved areas, with the impact likely strongest toward the end of the forecast period due to the time required for construction, equipment installation, and staffing. 

*Our forecasts treat driver/restraint impacts as directional, not additive. The impact forecasts reflect baseline growth, mix effects, and variable interactions.

Segment Analysis

By Cancer Type: Hepatocellular Carcinoma Leads While Hepatoblastoma Supports Future Growth

Hepatocellular carcinoma held 74.88% of the South America liver cancer treatment market revenue by cancer type in 2025. Its scale reflects the regional burden of hepatitis B, hepatitis C, alcohol-related cirrhosis, and metabolic dysfunction-associated steatotic liver disease. A Brazilian multicenter study found that 77% of patients presented with BCLC-C disease, while first-line atezolizumab plus bevacizumab achieved a median overall survival of 15.9 months. Intrahepatic cholangiocarcinoma accounted for 15% of primary liver cancers, with 70% of Brazilian biliary tract cancer patients diagnosed at locally advanced or metastatic stages.

Hepatoblastoma is forecast to be the fastest-growing cancer-type segment, at a 19.18% CAGR through 2031. Growth reflects a low base and continued investment in pediatric oncology care, despite persistently high mortality among Brazilian children under 5 years of age. Brazil’s INCA-affiliated pediatric centers use the SIOPEL approach, combining preoperative cisplatin with surgery or liver transplantation for unresectable cases. PHITT consortium guidance, along with research on beta-catenin and GPC3, may expand future treatment options.

By Therapy: Targeted Therapy Grows Faster While Chemotherapy Retains the Largest Share

Chemotherapy accounted for 30.53% of the South America liver cancer treatment market share by therapy in 2025. It remains essential for patients ineligible for immunotherapy, transarterial chemoembolization (TACE) procedures using doxorubicin- or cisplatin-loaded drug-eluting beads, and gemcitabine-cisplatin treatment for biliary tract cancer. Public hospital availability supports its use in lower-resource settings. Limited molecular testing and infusion capacity outside major cities will sustain chemotherapy’s central role as systemic treatment options diversify.

Targeted therapy is projected to expand at an 18.25% CAGR through 2031, making it the fastest-growing therapy segment. Lenvatinib is increasingly used after atezolizumab plus bevacizumab failure, with the 2025 LEVIATHAN study reporting improved progression-free survival, overall survival, and disease control compared with sorafenib. Updated Brazilian Society of Hepatology recommendations list cabozantinib and ramucirumab as approved second-line options. Humanova’s 2025 distribution partnership with Bayer may extend access to sorafenib and regorafenib beyond the company’s direct sales footprint.

By End User: Hospitals and Clinics Lead While Specialty Cancer Centers Expand

Hospitals and clinics represented 59.10% of end-user revenue in 2025. Large public university hospitals and tertiary referral centers in S?o Paulo, Buenos Aires, Bogotá, and Santiago manage most treatments and concentrate TACE suites, multidisciplinary tumor boards, and transplant programs. These facilities also treat patients with advanced disease requiring complex systemic therapy. This concentration supports segment leadership but limits access outside major metropolitan areas.

Specialty cancer centers are forecast to grow at a 17.56% CAGR through 2031, supported by public investment and private network expansion in Brazil and Argentina. Oncoclínicas operated 144 units in 47 cities as of the third quarter of 2025 and planned to launch 50 new clinical trial projects by 2026. The network also operates the LIVER-R observational study in hepatobiliary cancer. Brazil’s 2024 Clinical Research Law and subcutaneous immunotherapy may further support ambulatory treatment delivery.

Geography Analysis

Brazil held 57.70% of regional revenue in 2025, with INCA estimating 10,700 new liver cancer cases annually. The country benefits from public university hospitals, private oncology networks, and local biosimilar manufacturers. A 2025 study across 14 Oncologia D’Or centers found that 77.9% of patients received atezolizumab plus bevacizumab as first-line treatment, with a median overall survival of 14.7 months and a 12-month survival of 57.0%. Brazil approved pembrolizumab for biliary tract cancer in September 2025, while metabolic dysfunction-associated steatotic liver disease accounted for 22.7% of immunotherapy-treated hepatocellular carcinoma patients in the source cohort.

Argentina is projected to be the fastest-growing geography, at a 19.56% CAGR from 2026 to 2031. Regulatory progress, outpatient treatment formats, and clinical research activity support its growth. Subcutaneous nivolumab was approved in February 2026, following the December 2024 approval of subcutaneous atezolizumab, and can be administered in under 5 minutes compared with 30-60 minutes for intravenous therapy. Chile’s Hospital Clínico Herminda Martín added six infusion chairs in April 2026, increasing planned monthly capacity from 477 to 795 sessions.

Peru and the Rest of South America have high potential but face the greatest operating constraints in the South America liver cancer treatment market. Hepatitis B endemicity in Peru’s Amazon region contributes to liver cancer burden, while access to TACE and systemic therapy remains limited. In Bolivia, Ecuador, Paraguay, Uruguay, Venezuela, and other markets, treatment is concentrated in public hospitals and primarily centers on systemic chemotherapy. At the same time, immunotherapy remains limited to a small private-sector patient group. Sustained public investment, workforce training, and reliable drug access will determine the expansion of treatment availability beyond major national centers.