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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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/6/1680 |
| _version_ | 1797613001377841152 |
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| author | Daniel M. Girardi Lara P. Sousa Thiago A. Miranda Fernanda N. C. Haum Gabriel C. B. Pereira Allan A. L. Pereira |
| author_facet | Daniel M. Girardi Lara P. Sousa Thiago A. Miranda Fernanda N. C. Haum Gabriel C. B. Pereira Allan A. L. Pereira |
| author_sort | Daniel M. Girardi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T06:49:48Z |
| format | Article |
| id | doaj.art-920cc22908f64f1cbc0b80313833e787 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T06:49:48Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-920cc22908f64f1cbc0b80313833e7872023-11-17T10:05:41ZengMDPI AGCancers2072-66942023-03-01156168010.3390/cancers15061680Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and PerspectivesDaniel M. Girardi0Lara P. Sousa1Thiago A. Miranda2Fernanda N. C. Haum3Gabriel C. B. Pereira4Allan A. L. Pereira5Hospital Sírio-Libanes, SGAS 613/614 Conjunto E Lote 95-Asa Sul, Brasília 70200-730, BrazilEscola Superior de Ciências em Saúde, SMHN Conjunto A Bloco 01 Edifício Fepecs-Asa Norte, Brasília 70710-907, BrazilEscola Superior de Ciências em Saúde, SMHN Conjunto A Bloco 01 Edifício Fepecs-Asa Norte, Brasília 70710-907, BrazilEscola Superior de Ciências em Saúde, SMHN Conjunto A Bloco 01 Edifício Fepecs-Asa Norte, Brasília 70710-907, BrazilHospital Sírio-Libanes, SGAS 613/614 Conjunto E Lote 95-Asa Sul, Brasília 70200-730, BrazilHospital Sírio-Libanes, SGAS 613/614 Conjunto E Lote 95-Asa Sul, Brasília 70200-730, BrazilHepatocellular 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.https://www.mdpi.com/2072-6694/15/6/1680hepatocellular carcinomaimmunotherapytargeted therapybiomarkersmolecular landscape |
| spellingShingle | Daniel M. Girardi Lara P. Sousa Thiago A. Miranda Fernanda N. C. Haum Gabriel C. B. Pereira Allan A. L. Pereira Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and Perspectives Cancers hepatocellular carcinoma immunotherapy targeted therapy biomarkers molecular landscape |
| title | Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and Perspectives |
| title_full | Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and Perspectives |
| title_fullStr | Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and Perspectives |
| title_full_unstemmed | Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and Perspectives |
| title_short | Systemic Therapy for Advanced Hepatocellular Carcinoma: Current Stand and Perspectives |
| title_sort | systemic therapy for advanced hepatocellular carcinoma current stand and perspectives |
| topic | hepatocellular carcinoma immunotherapy targeted therapy biomarkers molecular landscape |
| url | https://www.mdpi.com/2072-6694/15/6/1680 |
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