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

Abstract

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.

Efficacy of Lenvatinib Combined with PD-1 Inhibitor versus Sorafenib and PD-1 Inhibitor with or Without TACE for Hepatocellular Carcinoma with Extrahepatic Metastasis

“… 14 Nowadays, there are two approved agents (Sorafenib and Lenvatinib) as the first-line options in China. 26 In this study, we analyzed 229 consecutive HCC patients with EHM undergoing treatment with TKI combined PD-1 inhibitor as Sora+PD-1 group (n = 127) and Len+PD-1 group (n = 102). We found that, compared with Sora+PD-1 treatment, Len+PD-1 treatment had significantly better OS and PFS in HCC patient with EHM.…”

Integrated investigation of the clinical implications and targeted landscape for RNA methylation modifications in hepatocellular carcinoma

“…Tyrosine kinase inhibitor (TKI) sorafenib was approved by the USA FDA in 2007 for the treatment of advanced HCC. Increasing oral multi-targeted TKIs were subsequently awarded permission for use in treating HCC worldwide [31,32]. Furthermore, we evaluated the relationship between RM_Score and Sorafenib sensitivity.…”

Mechanism study of oleanolic acid derivative, K73-03, inducing cell apoptosis in hepatocellular carcinoma

“…This is mainly because the early diagnosis of liver cancer is very difficult, leading to the majority of patients with liver cancer being diagnosed as an advanced stage. At present, the efficacy of traditional systemic chemotherapy is very low, and the side effects are great [ 3 , 4 ]. Moreover, the liver cancer recurrence rate following 5 recurrence-free years after liver cancer treatment is high [ 5 ].…”