综述文章：肝细胞癌的全身治疗

StephenW

Review article: systemic treatment of hepatocellular carcinoma
Matthias Pinter
Markus Peck‐Radosavljevic
First published: 23 July 2018
https://doi.org/10.1111/apt.14913

The Handling Editor for this article was Professor Peter Hayes, and this uncommissioned review was accepted for publication after full peer‐review.
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Summary
Background

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.
Aim

To summarise the evolving field of systemic therapy of hepatocellular carcinoma.
Methods

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.
Results

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.
Conclusions

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.

StephenW

综述文章：肝细胞癌的全身治疗
马蒂亚斯品特
Markus Peck-Radosavljevic
首次发表：2018年7月23日
https://doi.org/10.1111/apt.14913

本文的处理编辑是Peter Hayes教授，这篇未经审查的评论在完全同行评审后被接受发表。
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背景

2007年酪氨酸激酶抑制剂索拉非尼的批准标志着治疗肝细胞癌的一个里程碑，因为索拉非尼是第一个显示晚期肝细胞癌患者生存获益的全身治疗。从那时起，许多药物在一线和二线治疗失败，并且在进一步的酪氨酸激酶抑制剂成功进行III期试验之前需要几乎十年。
目标

总结肝细胞癌全身治疗的演变领域。
方法

我们回顾了PubMed最近发表的研究以及最近会议上提供的数据。主要搜索术语包括肝细胞癌，酪氨酸激酶抑制剂，免疫疗法，免疫检查点抑制剂，索拉非尼，瑞格非尼，lenvatinib，cabozantinib，ramucirumab和nivolumab。
结果

我们讨论了自索拉非尼批准后靶向治疗的发展，包括失败和最新进展。我们还详细阐述了生物标志物未得到满足的需求，以指导治疗决策并讨论肝细胞癌免疫治疗的新兴领域。
结论

酪氨酸激酶抑制剂索拉非尼（第一线）和瑞格非尼（第二线）已被批准用于肝细胞癌，并且免疫检查点抑制剂nivolumab在美国获得了索拉非尼经历过的患者的有条件批准。第一线使用lenvatinib，索拉非尼患者使用cabozantinib和ramucirumab，在III期临床试验中，另外三种靶向治疗达到了主要终点，并可能很快被添加到治疗设备中。

StephenW

https://onlinelibrary.wiley.com/doi/full/10.1111/apt.14913

阳关Boy

速度要快些哈，中国每年携带者都在减少，再等几十年估计就剩下几百万的携带者了。