I Department of Internal Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, 55101 Mainz, Germany.
Dig Liver Dis. 2010 Jul;42 Suppl 3:S302-9. doi: 10.1016/S1590-8658(10)60521-X.
Hepatocellular carcinoma (HCC) is one of the most common and lethal malignancies worldwide. Due to late diagnosis and advanced underlying liver cirrhosis, only limited treatment options with marginal clinical benefits have been available in up to 70% of patients. However, major progress has been achieved with regard to surveillance, early diagnosis, and multimodal treatment approaches during the last years leading to an improvement in prognosis. Particularly, the increasing knowledge of molecular hepatocarcinogenesis today provides the opportunity for targeted therapy. The multikinase inhibitor sorafenib has broadened the therapeutic horizon for patients with advanced disease and is currently under investigation for patients in early and intermediate stages as adjuvant therapy after resection/local ablation or in combination with transcatheter arterial chemoembolization. Future research will continue to unravel the key signaling cascades in different subclasses of HCC patients according to their genomic and proteomic profiling. These approaches bear the potential to individualize anticancer therapy, in the end allowing treatment of those benefiting most and excluding those who do not. This article shortly reviews the current knowledge in the management of HCC and provides insights into future perspectives with a special focus on recent progress in multidisciplinary treatment modalities.
肝细胞癌(HCC)是全球最常见和最致命的恶性肿瘤之一。由于诊断较晚和基础肝硬化较严重,多达 70%的患者仅可获得有限的治疗选择,临床获益甚微。然而,近年来在监测、早期诊断和多模式治疗方法方面取得了重大进展,改善了预后。特别是,目前对分子肝癌发生机制的深入了解为靶向治疗提供了机会。多激酶抑制剂索拉非尼拓宽了晚期疾病患者的治疗范围,目前正在研究用于切除/局部消融后或与经导管动脉化疗栓塞联合使用的早期和中期患者的辅助治疗。未来的研究将继续根据不同亚类 HCC 患者的基因组和蛋白质组分析来阐明关键的信号转导级联。这些方法有可能实现个体化的抗癌治疗,最终使那些最受益的患者得到治疗,并排除那些没有受益的患者。本文简要回顾了 HCC 管理的现有知识,并深入探讨了未来的前景,特别关注多学科治疗模式的最新进展。