Kondo Shunsuke, Ueno Hideki, Morizane Chigusa, Okusaka Takuji
Division of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Gan To Kagaku Ryoho. 2010 Jul;37(7):1219-23.
In two randomized controlled trials (Sorafenib HCC Assessment Randomized Protocol trial and Asian Pacific trial), sorafenib has demonstrated a significantly favorable disease control rate, progression-free survival and overall survival in advanced hepatocellular carcinoma in comparison with placebo. It is presently acknowledged as a standard treatment for advanced hepatocellular carcinoma and is available worldwide. However, the survival benefit and toxicity of sorafenib have been in sufficient, so development of new agents has been more active recently. Development treatment of hepatocellular carcinoma revolves around molecular targeted drugs that target factors associated with tumor growth and angiogenesis. In Japan, clinical trials have involved cytotoxic therapies, but the development of systemic agents for advanced hepatocellular carcinoma has been lacking despite no clear benefits from traditional cytotoxic therapies. S-1, an oral fluoropyrimidine, is currently under evaluation for the treatment of hepatocellular carcinoma in randomized controlled trials. Systemic chemotherapy for hepatocellular carcinoma has been greatly advancing, and further improvements of chemotherapy in hepatocellular carcinoma are expected.
在两项随机对照试验（索拉非尼肝癌评估随机方案试验和亚太试验）中，与安慰剂相比，索拉非尼在晚期肝细胞癌中显示出显著更好的疾病控制率、无进展生存期和总生存期。目前它被公认为晚期肝细胞癌的标准治疗方法，且在全球范围内均可获得。然而，索拉非尼的生存获益和毒性尚不充分，因此最近新型药物的研发更为活跃。肝细胞癌的治疗研发围绕着针对与肿瘤生长和血管生成相关因子的分子靶向药物展开。在日本，临床试验涉及细胞毒性疗法，但尽管传统细胞毒性疗法并无明确益处，晚期肝细胞癌全身用药的研发却一直不足。口服氟嘧啶S-1目前正在随机对照试验中接受肝细胞癌治疗评估。肝细胞癌的全身化疗一直在大幅推进，预计肝细胞癌化疗将进一步得到改善。
