Advances in the Pharmacologic Treatment of Hepatocellular Carcinoma
Advances in the Pharmacologic Treatment of Hepatocellular Carcinoma
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DOI：
10.2174/1574884710666151020100059
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发表时间：
2015-01-01
影响因子：
3.2
通讯作者：
Gusani, Niraj J.
中科院分区：
文献类型：
--
作者：
Bhayani, Neil H.;Jiang, Yixing;Gusani, Niraj J.
肝细胞癌（HCC）的药物治疗是一个积极的研究领域，因为只有不到25%的患者适合根治性切除或移植。单药阿霉素（以前的标准治疗）产生了10%的肿瘤缓解，但导致了严重的毒性。NCCN的最终建议是仅根据临床方案进行细胞毒性化疗。最近，具有更特异性靶点的新药迫使人们重新考虑姑息化疗在临床实践中的应用。贝伐单抗是一种有前途的治疗方法，但数据仅限于2期试验，没有令人印象深刻的结果。索拉非尼是一种原型多激酶抑制剂，它在晚期HCC中表现出一些但有限的生存益处。这后来成为护理标准。表皮生长因子受体、雷帕霉素（mTOR）通路的靶标、转化生长因子-β和细胞周期蛋白依赖性激酶已成为正在进行的潜在治疗研究的最近靶标。总的来说，目前的治疗方法是如此有前途，在治愈性治疗后的辅助治疗正在研究中，以减少复发。
Medical therapy for hepatocellular carcinoma (HCC) is an area of active investigation because fewer than 25% of patients are candidates for curative resection or transplantation. Single agent doxorubicin, the former standard of care, generated a 10% tumor response but resulted in substantial toxicity. The resulting recommendation of the NCCN has been to administer cytotoxic chemotherapy only under clinical protocol. More recently, newer drugs with more specific targets have forced re-consideration of palliative chemotherapy in clinical practice. Bevacizumab is a promising therapy but data is limited to Phase 2 trials without impressive results. Sorafenib is the prototype multi-kinase inhibitor, which has demonstrated some but limited survival benefit in advanced HCC. This has subsequently become the standard of care. Epidermal growth factor receptor, the target of rapamycin (mTOR) pathway, transforming growth factor-beta, and cyclin-dependent kinases have been recent targets of ongoing study for potential therapeutics. Overall, current therapeutics have been so promising that adjuvant therapy after curative treatment in under investigation to reduce recurrence.