Τίτλος:
Hepatocellular Carcinoma: An Overview of the Changing Landscape of
Treatment Options
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The last three years have seen remarkable progress in comprehending
predisposing factors and upgrading our treatment arsenal concerning
hepatocellular carcinoma (HCC). Until recently, there were no means to
withstand the progression of viral hepatitis-associated liver cirrhosis
to HCC. A deeper understanding of the molecular mechanism of the
disease, the use of biomarkers, and the follow-up, allowed us to realize
that conventional chemotherapy failing to increase survival in patients
with advanced HCC tends to be exiled from clinical practice.
Multi-kinase inhibitors (TKIs) such as sorafenib, lenvatinib targeting
mainly the vascular endothelial growth factor receptors 1-3 VEGFRs 1-3
provided until recently the standard of care for these patients, as
first- or second-line treatment. Since May 2020, the atezolizumab plus
bevacizumab combination (immunotherapy plus antiVEGF) has become the new
reference standard in first-line HCC treatment. Additionally,
anti-programmed cell death protein 1 (anti-PD-1) immunotherapy can be
used as a second-line treatment following first-line treatment's
failure. Phase III clinical trials have recently suggested the efficacy
of novel anti-angiogenic factors such as cabozantinib and ramucirumab as
a second-line treatment option. With considerations about toxicity
arising, clinical trials are investigating combinations of the
aforementioned targeted therapies with immunotherapy as first-line
treatment. This paper aims to perform a systematic review describing the
evolving treatment options for HCC over the last decades, ranging from
neoadjuvant treatment to systemic therapy of advanced-stage HCC. With
the landscape of HCC treatment shifting towards novel agents the forming
of a new therapeutic algorithm for HCC seems to be imperative.
Συγγραφείς:
Koulouris, Andreas
Tsagkaris, Christos
Spyrou, Vasiliki and
Pappa, Eleni
Troullinou, Aikaterini
Nikolaou, Michail
Περιοδικό:
JOURNAL OF HEPATOCELLULAR CARCINOMA
Εκδότης:
Dove Medical Press Ltd
Λέξεις-κλειδιά:
hepatocellular carcinoma; immunotherapy; targeted therapy; tyrosine
kinase inhibitors; biomarkers
