Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and Perspectives

Hepatocellular carcinoma often develops in the context of chronic liver disease. It is the sixth most frequently diagnosed cancer and the third most common cause of cancer-related mortality worldwide. Although the mainstay of therapy is surgical resection, most patients are not eligible because of l...

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Bibliographic Details
Published in:Cancers 2023-03, Vol.15 (6), p.1680
Main Authors: Girardi, Daniel M, Sousa, Lara P, Miranda, Thiago A, Haum, Fernanda N C, Pereira, Gabriel C B, Pereira, Allan A L
Format: Article
Language:English
Subjects:
Alcohol
Antigens
Bevacizumab
Cancer
Cancer therapies
Care and treatment
Cell cycle
Clinical trials
Disease control
Hepatitis B
Hepatitis C
Hepatocellular carcinoma
Hepatoma
Immune system
Immunotherapy
Infections
Interferon
Kinases
Ligands
Liver cancer
Liver cirrhosis
Liver diseases
Medical prognosis
Mutation
Patients
Protein-tyrosine kinase
Review
Survival
Tumors
Vascular endothelial growth factor
Viral infections
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Summary:Hepatocellular carcinoma often develops in the context of chronic liver disease. It is the sixth most frequently diagnosed cancer and the third most common cause of cancer-related mortality worldwide. Although the mainstay of therapy is surgical resection, most patients are not eligible because of liver dysfunction or tumor extent. Sorafenib was the first tyrosine kinase inhibitor that improved the overall survival of patients who failed to respond to local therapies or had advanced disease, and for many years, it was the only treatment approved for the first-line setting. However, in recent years, trials have demonstrated an improvement in survival with treatments based on immunotherapy and new targeting agents, thereby extending the treatment options. A phase III trial showed that a combination of immunotherapy and targeted therapy, including atezolizumab plus bevacizumab, improved survival in the first-line setting, and is now considered the new standard of care. Other agents and combinations are being tested, including the combination of nivolumab plus ipilimumab and tremelimumab plus durvalumab, and they reportedly have clinical benefits. The aim of this manuscript is to review the latest approved therapeutic options in first- and second-line settings for advanced HCC and discuss future perspectives.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15061680