Systemic treatment of advanced hepatocellular carcinoma: From disillusions to new horizons

Abstract Hepatocellular carcinoma (HCC) is an aggressive malignancy, which accounts for a third of all cancer deaths globally each year. The management of patients with HCC is complex, as both the tumour stage and any underlying liver disease must be considered conjointly. Since the approval of sora...

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Bibliographic Details
Published in:European journal of cancer (1990) 2015-02, Vol.51 (3), p.327-339
Main Authors: Hollebecque, Antoine, Malka, David, Ferté, Charles, Ducreux, Michel, Boige, Valérie
Format: Article
Language:English
Subjects:
Angiogenesis Inhibitors - therapeutic use
Antineoplastic Agents - therapeutic use
Carcinoma, Hepatocellular - drug therapy
Carcinoma, Hepatocellular - pathology
Chemotherapy, Adjuvant
Disease Progression
Drug development
Drugs, Investigational - therapeutic use
Hematology, Oncology and Palliative Medicine
Hepatocellular carcinoma
Humans
Liver Neoplasms - drug therapy
Liver Neoplasms - pathology
Molecular biomarkers
Molecular targeted agents
Neoadjuvant Therapy
Niacinamide - analogs & derivatives
Niacinamide - therapeutic use
Phenylurea Compounds - therapeutic use
Signalling pathway
Sorafenib
Systemic treatment
Treatment Failure
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Summary:Abstract Hepatocellular carcinoma (HCC) is an aggressive malignancy, which accounts for a third of all cancer deaths globally each year. The management of patients with HCC is complex, as both the tumour stage and any underlying liver disease must be considered conjointly. Since the approval of sorafenib in advanced HCC, several phase III clinical trials have failed to demonstrate any superiority over sorafenib in the frontline setting, and no agent has been shown to impact outcomes after sorafenib failure. This review will focus on the range of experimental therapeutics for patients with advanced HCC and highlight the successes and failures of these treatments as well as areas for future development. Specifics such as dose limiting toxicity and safety profile in patients with liver dysfunction related to the underlying chronic liver disease should be considered when developing therapies in HCC. Finally, robust validated and reproducible surrogate end-points as well as predictive biomarkers should be defined in future randomised trials.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2014.12.005