Combined locoregional and systemic therapy for advanced hepatocellular carcinoma: finally, the future is obscure

Farsad, Khashayar; Nabavizadeh, Nima; Kardosh, Adel; Jou, Janice H.; Naugler, Willscott E.; Kolbeck, Kenneth J.

doi:10.21037/atm-20-4164

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…HuMax-IL8 (now known as BMS-986253) is a novel, fully human monoclonal antibody that inhibits interleukin-8 (IL-8) [79]. Combining locoregional with systemic therapy is also under investigation [80]. Among multiple studies being conducted, the EMERALD-1 trial is a randomized, double-blind, placebo-controlled phase III study assessing anti-PD-1 agent durvalumab alongside TACE therapy with or without bevacizumab [81].…”

Section: Future Directionsmentioning

confidence: 99%

Treatment of Advanced Hepatocellular Carcinoma

Aryan¹,

Altshuler²,

Qian³

et al. 2022

Hepatocellular Carcinoma - Challenges and Opportunities of a Multidisciplinary Approach

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Hepatocellular Carcinoma (HCC) is the fifth most common cancer and represents the fourth most common cause of cancer related death worldwide. Treatment of HCC is dictated based upon cancer stage, with the most universally accepted staging system being the Barcelona Clinic Liver Cancer (BCLC) staging system. This system takes into account tumor burden, active liver function, and patient performance status. BCLC stage C HCC is deemed advanced disease, which is often characterized by preserved liver function (Child-Pugh A or B) with potential portal invasion, extrahepatic spread, cancer related symptoms, or decreased performance status. Sorafenib has been the standard treatment for advanced HCC over the past decade; however, its use is limited by low response rates, decreased tolerance, and limited survival benefit. Researchers and clinicians have been investigating effective treatment modalities for HCC over the past several years with a focus on systemic regimens, locoregional therapy, and invasive approaches. In this systemic review, we discuss the management of advanced HCC as well as the ongoing research on various treatment opportunities for these patients.

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Section: Future Directionsmentioning

confidence: 99%

Treatment of Advanced Hepatocellular Carcinoma

Aryan¹,

Altshuler²,

Qian³

et al. 2022

Hepatocellular Carcinoma - Challenges and Opportunities of a Multidisciplinary Approach

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“…These factors underline the importance of MDT, which only can provide the required evidence-based comprehensive recommendations on tumor characteristics and the clinical stage, molecular pathological diagnosis, and treatment options. Patients suffering from mid-stage and advanced HCC often require multidisciplinary therapies, which combine local and systemic treatment options [96]. More than 90% of HCC patients have underlying chronic liver disease or cirrhosis and because of the toxicity risk of tumor therapies, a liver specialist or gastroenterologist should definitely be a part of HCC-MDT [97].…”

Section: Role Of Multidisciplinary Teamsmentioning

confidence: 99%

Systemic Therapy for Hepatocellular Carcinoma: Chinese Consensus-Based Interdisciplinary Expert Statements

Sun

Wen

et al. 2022

Liver Cancer

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Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer and causes many cancer-related deaths worldwide; in China it is the second most prevalent cause of cancer deaths. Most patients are diagnosed clinically with advanced stage disease. Summary: For more than a decade, sorafenib, a small molecular weight tyrosine kinase-inhibitor (SMW TKI) was the only molecular targeted drug available with a survival benefit for the treatment of advanced HCC. With the development of novel TKIs and immune checkpoint inhibitors (ICIs) for advanced HCC, the management of patients has been greatly improved. However, though angiogenic-based targeted therapy remains the backbone for the systemic treatment of HCC, to date no Chinese guidelines for novel molecular targeted therapies to treat advanced HCC have been established. Our interdisciplinary panel on the treatment of advanced HCC comprising hepatologists, hepatobiliary surgeons, oncologists，radiologists，pathologists, orthopedic surgeons, traditional Chinese medicine physicians and interventional radiologists have reviewed the literature in order to develop updated treatment regimens. Key Messages: Panel consensus statements for the appropriate use of new molecular targeted drugs including doses, combination therapies, adverse reaction management as well as efficacy evaluation and predictions for treatment of advanced HCC with evidence levels based on published data are presented, thereby providing an overview of molecular targeted therapies for healthcare professionals.

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“…Based on these favorable results, attempts at synergizing locoregional therapy with immunotherapy has rapidly proliferated the clinical trial landscape for HCC, pushing this combination in earlier stages as well. 57–60 Locoregional therapies have the capability of generating tumor antigens that can work with immune-checkpoint inhibition to enhance an anti-tumor immune response. 61 Phase III clinical trials are currently underway examining whether combination ablation and systemic/immunotherapy can improve recurrence rates and overall survival in early-stage HCC.…”

Section: Combination Therapiesmentioning

confidence: 99%

“… 61 Phase III clinical trials are currently underway examining whether combination ablation and systemic/immunotherapy can improve recurrence rates and overall survival in early-stage HCC. 57 , 59 …”

Section: Combination Therapiesmentioning

confidence: 99%