Unit:
Library of the School of Health SciencesΠΜΣ Χειρουργική Ογκολογία
Author:
Bakogeorgos Alexandros-Marios
Supervisors info:
Θεοδοσόπουλος Θεοδόσιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Φραγκουλίδης Γεώργιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πολυδώρου Ανδρέας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Νεότερες εξελίξεις στη συστηματική θεραπεία του ηπατοκυτταρικού καρκινώματος. Πώς τροποποιούν το θεραπευτικό σχεδιασμό;
Translated title:
New advances in the systemic treatment for Hepatocellular carcinoma. How do they modify the therapeutic plan?
Summary:
Hepatocellular carcinoma (HCC) represents the second leading cause of cancer-related death, occurs almost always in the setting of chronic liver disease and its prognosis is influenced not only by the extent of the neoplastic disease but by the severity of the underlying liver disease and the hepatic reserves. When HCC is diagnosed and treated at an early stage the prognosis is much better, as liver transplantation, hepatic resection and local ablative therapies are associated with good survival rates. Systemic therapy is appropriate for patients with advanced, unresectable or metastatic HCC who are unsuitable for locoregional therapy and whose liver function is sufficient to tolerate treatment. HCC is considered to be a relatively chemotherapy-refractory tumor and until 2008, there was no effective approved systemic therapy for patients with advanced HCC after failure of locoregional therapies. Given the vascular nature of HCC, antiangiogenic agents have been studied extensively and several molecularly targeted agents have already been approved as first and second-line treatment options, while immune checkpoint inhibitors have further extended the continuously changing therapeutic landscape. The main limitation for precision medicine in HCC is that even though important advances have been made in the field of HCC pathogenesis, the most frequent detected and potential actionable genetic alterations are infrequent. Herein we provide a comprehensive review of HCC epidemiology, risk factors, pathology, molecular biology, clinical evaluation and the clinical trial data of the currently approved treatment options for first- (i.e. atezolizumab plus bevacizumab, lenvatinib, sorafenib) and second-line (i.e. regorafenib, cabozantinib, nivolumab with or without ipilimumab, pembrolizumab, ramucirumab) treatment of patients with HCC. The treatment algorithm for inoperable, advanced HCC has not been defined yet and prospective randomized trials comparing the safety and the efficacy of the novel treatment agents and combinations are required.
Main subject category:
Health Sciences
Keywords:
Hepatocellular carcinoma, Liver cancer, Targeted therapy, Novel agents, Immune Checkpoint inhibitors, Systemic treatment, Treatment algorithm
Number of references:
226
File:
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Bakogeorgos Marios.pdf
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