New Frontiers in the Medical Therapy of Hepatocellular Carcinoma.
Hepatocellular carcinoma
Immunotherapy
Systemic treatments
Journal
Chemotherapy
ISSN: 1421-9794
Titre abrégé: Chemotherapy
Pays: Switzerland
ID NLM: 0144731
Informations de publication
Date de publication:
2022
2022
Historique:
received:
15
11
2021
accepted:
20
12
2021
pubmed:
10
1
2022
medline:
24
8
2022
entrez:
9
1
2022
Statut:
ppublish
Résumé
Hepatocellular carcinoma (HCC) is the most common primary liver tumor, and it rates fourth as a cause of cancer-related death. The presence of underlying liver disease and poor chemosensitivity pose major treatment challenges in the management of HCC. However, in the last few years, the therapeutic scenario has substantially changed, and immunotherapy in the form of immune checkpoint inhibitors (ICPIs) has become an essential therapeutic strategy in this field. After controversial results of monotherapy, ICPIs have been mainly investigated in association with antiangiogenic agents or as dual checkpoint inhibition. The combination of atezolizumab plus bevacizumab has become the new therapeutic standard for unresectable HCC. Currently, a number of ICPI-based combinations are being studied in phase III clinical trials as front-line therapy for advanced HCC, with growing interest in integration of early-stage disease management in the form of adjuvant or neoadjuvant therapies. With most of the trials investigating ICPIs as first-line treatment, the second-line scenario relies mainly on tyrosine kinase inhibitors, which however have not been formally trialed after ICPIs. In this review, we summarize the main therapeutic advances in the systemic management of HCC focusing on the most relevant ongoing trials. We also discuss the main issues arising from a such rapidly evolving field including therapeutic sequencing and patient stratification.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatocellular carcinoma (HCC) is the most common primary liver tumor, and it rates fourth as a cause of cancer-related death. The presence of underlying liver disease and poor chemosensitivity pose major treatment challenges in the management of HCC. However, in the last few years, the therapeutic scenario has substantially changed, and immunotherapy in the form of immune checkpoint inhibitors (ICPIs) has become an essential therapeutic strategy in this field.
SUMMARY
CONCLUSIONS
After controversial results of monotherapy, ICPIs have been mainly investigated in association with antiangiogenic agents or as dual checkpoint inhibition. The combination of atezolizumab plus bevacizumab has become the new therapeutic standard for unresectable HCC. Currently, a number of ICPI-based combinations are being studied in phase III clinical trials as front-line therapy for advanced HCC, with growing interest in integration of early-stage disease management in the form of adjuvant or neoadjuvant therapies. With most of the trials investigating ICPIs as first-line treatment, the second-line scenario relies mainly on tyrosine kinase inhibitors, which however have not been formally trialed after ICPIs.
KEY MESSAGES
CONCLUSIONS
In this review, we summarize the main therapeutic advances in the systemic management of HCC focusing on the most relevant ongoing trials. We also discuss the main issues arising from a such rapidly evolving field including therapeutic sequencing and patient stratification.
Identifiants
pubmed: 34999584
pii: 000521837
doi: 10.1159/000521837
doi:
Substances chimiques
Angiogenesis Inhibitors
0
Bevacizumab
2S9ZZM9Q9V
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
164-172Informations de copyright
© 2022 The Author(s). Published by S. Karger AG, Basel.