2022
DOI: 10.1007/s10147-022-02166-0
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New treatment paradigm with systemic therapy in intermediate-stage hepatocellular carcinoma

Abstract: Since the approval of sorafenib for the treatment of unresectable hepatocellular carcinoma in 2007 (in 2009 in Japan), five more regimens have been approved: lenvatinib, and atezolizumab plus bevacizumab for first-line treatment, and regorafenib, cabozantinib, and ramucirumab for second-line treatment, which are currently available for clinical use. The positive results of durvalumab, a programmed cell death ligand 1 antibody, plus tremelimumab, an anti-cytotoxic T-lymphocyte-associated protein 4 antibody, wer… Show more

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Cited by 30 publications
(27 citation statements)
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“…Additionally, these findings emphasise the concept of therapeutic hierarchy [ 36 ], suggesting that patient treatment should be dictated by the efficacy of each therapy with independence from the tumour stage. In the near future, the diffusion of new systemic drugs [ 37 , 38 ] could increase even further the potential of downstaging therapies, increasing the number of patients with intermediate HCC likely to benefit from LT and changing the current principles of therapeutic hierarchy.…”
Section: Discussionmentioning
confidence: 99%
“…Additionally, these findings emphasise the concept of therapeutic hierarchy [ 36 ], suggesting that patient treatment should be dictated by the efficacy of each therapy with independence from the tumour stage. In the near future, the diffusion of new systemic drugs [ 37 , 38 ] could increase even further the potential of downstaging therapies, increasing the number of patients with intermediate HCC likely to benefit from LT and changing the current principles of therapeutic hierarchy.…”
Section: Discussionmentioning
confidence: 99%
“…This concept is also being demonstrated in clinical practice. Recent data shows that Atezo/Bev plus locoregional therapy resulted in curative conversion in 35% of patients and cancer-free status in 23% of patients (11)(12)(13)(14).…”
Section: Editorial Commentarymentioning
confidence: 99%
“…As a highly heterogeneous cancer, the treatment of HCC is similarly challenging [ 16 ]. As the standard first-line treatment modality for intermediate stage HCC, transcatheter arterial chemotherapy (TACE) urgently needs to be improved [ 17 ]. The systemic therapy of advanced HCC is still limited in traditional chemotherapeutics (e.g., Oxaliplatin, Fluorouracil and Lenvatinib).…”
Section: Introductionmentioning
confidence: 99%