How Immunotherapy Has Changed the Continuum of Care in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is one of the leading causes of death worldwide. The use of local treatment, such as surgical resection, liver transplant, and local ablation, has improved the survival of patients with HCC detected at an early stage. Until recently, the treatment of patients with meta...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/18/4719 |
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| author | Giulia Martini Davide Ciardiello Fernando Paragliola Valeria Nacca Walter Santaniello Fabrizio Urraro Maria Stanzione Marco Niosi Marcello Dallio Alessandro Federico Francesco Selvaggi Carminia Maria Della Corte Stefania Napolitano Fortunato Ciardiello Erika Martinelli |
| author_facet | Giulia Martini Davide Ciardiello Fernando Paragliola Valeria Nacca Walter Santaniello Fabrizio Urraro Maria Stanzione Marco Niosi Marcello Dallio Alessandro Federico Francesco Selvaggi Carminia Maria Della Corte Stefania Napolitano Fortunato Ciardiello Erika Martinelli |
| author_sort | Giulia Martini |
| collection | DOAJ |
| description | Hepatocellular carcinoma (HCC) is one of the leading causes of death worldwide. The use of local treatment, such as surgical resection, liver transplant, and local ablation, has improved the survival of patients with HCC detected at an early stage. Until recently, the treatment of patients with metastatic disease was limited to the use of the multikinase inhibitor (MKI) sorafenib with a marginal effect on survival outcome. New target approaches, such as the oral MKI lenvatinib in first-line treatment and regorafenib, ramucirumab, and cabozantinib in later lines of therapy, have demonstrated efficacy in patients with preserved liver function (Child–Pugh class A) and good performance status. On the other hand, the implementation of immune checkpoint inhibitors directed against PD-1 (nivolumab and pembrolizumab), PD-L1 (atezolizumab), and anti-CTLA4 (ipilimumab) in the management of advanced HCC has strongly changed the continuum of care of HCC. Future research should include the evaluation of molecular biomarkers that can help patient selection and provide new insight on potential combined approaches. In this review, we provide an overview of the clinical evidence of the use of immune checkpoint inhibitors in HCC, and discuss how immunotherapy has been implemented into the continuum of HCC care. |
| first_indexed | 2024-03-10T07:50:48Z |
| format | Article |
| id | doaj.art-ecf58581bf9d4c48a3c742382ac7ea06 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T07:50:48Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-ecf58581bf9d4c48a3c742382ac7ea062023-11-22T12:19:31ZengMDPI AGCancers2072-66942021-09-011318471910.3390/cancers13184719How Immunotherapy Has Changed the Continuum of Care in Hepatocellular CarcinomaGiulia Martini0Davide Ciardiello1Fernando Paragliola2Valeria Nacca3Walter Santaniello4Fabrizio Urraro5Maria Stanzione6Marco Niosi7Marcello Dallio8Alessandro Federico9Francesco Selvaggi10Carminia Maria Della Corte11Stefania Napolitano12Fortunato Ciardiello13Erika Martinelli14Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyOncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyOncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyOncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyChirurgia Epatobiliare e Trapianto di Fegato, A.O.R.N. Antonio Cardarelli, 80100 Naples, ItalyRadiologia, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyMalattie Infettive, Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyEpato-Gastroenterologia, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyEpato-Gastroenterologia, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyEpato-Gastroenterologia, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyDipartimento di Scienze Mediche e Chirurgiche Avanzate, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyOncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyOncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyOncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyOncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli”, 80100 Naples, ItalyHepatocellular carcinoma (HCC) is one of the leading causes of death worldwide. The use of local treatment, such as surgical resection, liver transplant, and local ablation, has improved the survival of patients with HCC detected at an early stage. Until recently, the treatment of patients with metastatic disease was limited to the use of the multikinase inhibitor (MKI) sorafenib with a marginal effect on survival outcome. New target approaches, such as the oral MKI lenvatinib in first-line treatment and regorafenib, ramucirumab, and cabozantinib in later lines of therapy, have demonstrated efficacy in patients with preserved liver function (Child–Pugh class A) and good performance status. On the other hand, the implementation of immune checkpoint inhibitors directed against PD-1 (nivolumab and pembrolizumab), PD-L1 (atezolizumab), and anti-CTLA4 (ipilimumab) in the management of advanced HCC has strongly changed the continuum of care of HCC. Future research should include the evaluation of molecular biomarkers that can help patient selection and provide new insight on potential combined approaches. In this review, we provide an overview of the clinical evidence of the use of immune checkpoint inhibitors in HCC, and discuss how immunotherapy has been implemented into the continuum of HCC care.https://www.mdpi.com/2072-6694/13/18/4719HCCimmune checkpoint inhibitorsmultimodal treatmentbiomarkersAFP |
| spellingShingle | Giulia Martini Davide Ciardiello Fernando Paragliola Valeria Nacca Walter Santaniello Fabrizio Urraro Maria Stanzione Marco Niosi Marcello Dallio Alessandro Federico Francesco Selvaggi Carminia Maria Della Corte Stefania Napolitano Fortunato Ciardiello Erika Martinelli How Immunotherapy Has Changed the Continuum of Care in Hepatocellular Carcinoma Cancers HCC immune checkpoint inhibitors multimodal treatment biomarkers AFP |
| title | How Immunotherapy Has Changed the Continuum of Care in Hepatocellular Carcinoma |
| title_full | How Immunotherapy Has Changed the Continuum of Care in Hepatocellular Carcinoma |
| title_fullStr | How Immunotherapy Has Changed the Continuum of Care in Hepatocellular Carcinoma |
| title_full_unstemmed | How Immunotherapy Has Changed the Continuum of Care in Hepatocellular Carcinoma |
| title_short | How Immunotherapy Has Changed the Continuum of Care in Hepatocellular Carcinoma |
| title_sort | how immunotherapy has changed the continuum of care in hepatocellular carcinoma |
| topic | HCC immune checkpoint inhibitors multimodal treatment biomarkers AFP |
| url | https://www.mdpi.com/2072-6694/13/18/4719 |
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