Department of Gastroenterology, Hospital Servidor Publico, Sao Paulo, Brazil.
Ann Hepatol. 2011 Jan-Mar;10(1):21-7.
Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world in terms of incidence, accounting for approximately 630 thousand new cases per year; in addition, HCC is the third most common cause of cancer death. Worldwide, the greatest risk factors for HCC are the infections caused by hepatitis B and C viruses, which increase the risk of developing the disease by about 20 times. The standard treatment in the early stages of the disease, such as surgical resection, local ablation and liver transplantation, are able to cure a proportion of patients, but most cases of HCC present in advanced stages, precluding the use of such treatments with curative intent. In these advanced stages, systemic treatments are commonly used. Unfortunately, chemotherapy with conventional cytotoxic agents is ineffective and does not seem to modify the natural history of disease. Treatment options for patients with advanced HCC are extremely limited, but the identification of signaling pathways, and the recognition of the role of these pathways in the pathogenesis of the disease resulted in the development of drugs directed at specific therapeutic targets. One such drug is Sorafenib, a kinase inhibitor with antiangiogenic and antiproliferative properties. In conclusion, Sorafenib has demonstrated survival benefits in patients with advanced HCC, thus representing a new standard reference for systemic treatment in these cases.
肝细胞癌 (HCC) 是全球发病率排名第六的癌症，每年约有 63 万新发病例；此外，HCC 是癌症死亡的第三大主要原因。在全球范围内，HCC 的最大风险因素是乙型和丙型肝炎病毒引起的感染，这使患病风险增加了约 20 倍。在疾病的早期阶段，如手术切除、局部消融和肝移植等标准治疗方法能够治愈一部分患者，但大多数 HCC 病例处于晚期，排除了具有治愈意图的此类治疗方法的应用。在这些晚期阶段，通常使用全身治疗。不幸的是，传统细胞毒性药物的化疗无效，似乎也不能改变疾病的自然病程。晚期 HCC 患者的治疗选择极为有限，但信号通路的鉴定以及这些通路在疾病发病机制中的作用的认识导致了针对特定治疗靶点的药物的开发。索拉非尼就是这样一种药物，它是一种具有抗血管生成和抗增殖作用的激酶抑制剂。总之，索拉非尼在晚期 HCC 患者中显示出生存获益，因此成为这些情况下全身治疗的新标准参考。
