Review article: systemic treatment of hepatocellular carcinoma.

Review article: systemic treatment of hepatocellular carcinoma.
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DOI:
10.1111/apt.14913
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发表时间:
2018-09
影响因子:
7.6
通讯作者:
Peck-Radosavljevic M
Peck-Radosavljevic M
中科院分区:
医学1区
文献类型:
--
作者:
Pinter M;Peck-Radosavljevic M

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酪氨酸激酶抑制剂索拉非尼在2007年的批准标志着肝细胞癌治疗的一个里程碑,因为索拉非尼是第一个在晚期肝细胞癌患者中显示生存益处的全身治疗。从那时起,许多药物在一线和二线治疗中失败,又花了近十年时间,直到更多的酪氨酸激酶抑制剂在III期试验中成功。总结肝癌系统治疗的发展领域。我们回顾了最近发表的研究,确定从PubMed和数据在最近的会议。主要检索词包括肝细胞癌、酪氨酸激酶抑制剂、免疫治疗、免疫检查点抑制剂、索拉非尼、瑞格非尼、乐伐替尼、卡博替尼、雷莫芦单抗和纳武单抗。我们讨论了索拉非尼批准以来靶向治疗的进展,包括失败和最新进展。我们还阐述了未满足的需要的生物标志物,以指导治疗决策,并讨论了新兴领域的免疫治疗肝细胞癌。酪氨酸激酶抑制剂索拉非尼(一线)和瑞戈非尼(二线)已被批准用于肝细胞癌,免疫检查点抑制剂纳武单抗在美国获得了索拉非尼经验患者的有条件批准。随着乐伐替尼作为一线药物,以及卡博替尼和雷莫芦单抗用于索拉非尼治疗的患者,又有三种靶向治疗在III期试验中达到了主要终点,并可能很快被添加到治疗设备中。
The approval of the tyrosine kinase inhibitor sorafenib in 2007 marked a milestone in the treatment of hepatocellular carcinoma, as sorafenib was the first systemic therapy to show a survival benefit in patients with advanced hepatocellular carcinoma. Since then many drugs failed in the first‐ and second‐line setting and it took almost another decade until further tyrosine kinase inhibitors succeeded in phase III trials. To summarise the evolving field of systemic therapy of hepatocellular carcinoma. We reviewed recently published studies identified from PubMed and data presented at recent meetings. Main search terms included hepatocellular carcinoma, tyrosine kinase inhibitors, immunotherapy, immune checkpoint inhibitors, sorafenib, regorafenib, lenvatinib, cabozantinib, ramucirumab, and nivolumab. We discuss the evolution of targeted therapies since the approval of sorafenib including failures and recent advances. We also elaborate the unmet need of biomarkers to guide treatment decisions and discuss the emerging field of immunotherapy in hepatocellular carcinoma. The tyrosine kinase inhibitors sorafenib (first line) and regorafenib (second line) have been approved for hepatocellular carcinoma, and the immune checkpoint inhibitor nivolumab obtained conditional approval for sorafenib‐experienced patients in the United States. With lenvatinib in the first line, and cabozantinib and ramucirumab in sorafenib‐experienced patients, three more targeted therapies reached their primary endpoint in phase III trials and may soon be added to the treatment armamentarium.
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