Kim Hwi Young, Park Joong-Won
Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
Center for Liver Cancer, National Cancer Center, Gyeonggi-do, Republic of Korea.
Liver Cancer. 2014 Mar;3(1):9-17. doi: 10.1159/000343854.
Sorafenib, a multikinase inhibitor that targets angiogenesis in hepatocellular carcinoma (HCC), has become a standard treatment for advanced-stage HCC and has shown survival benefits in recent clinical trials. Transarterial chemoembolization (TACE) and sorafenib are currently standard treatments for intermediate and advanced-stage HCC, respectively. Combined locoregional therapy, including TACE and molecular targeted therapies such as sorafenib, is an issue under active investigation in an attempt to improve the outcomes of patients with unresectable HCC.
Various clinical trials of these combined strategies have been conducted; however, the designs of these studies are diverse in terms of treatment modalities and schedules; comparisons with controls, baseline tumor stages, and hepatic functional reserves; and outcome measures.
This article reviews heterogeneity in the design of recent clinical trials of combined locoregional and molecular targeted therapies and briefly addresses future study directions.
索拉非尼是一种多激酶抑制剂，可靶向肝细胞癌（HCC）中的血管生成，已成为晚期HCC的标准治疗方法，并在近期临床试验中显示出生存获益。经动脉化疗栓塞术（TACE）和索拉非尼目前分别是中期和晚期HCC的标准治疗方法。包括TACE和索拉非尼等分子靶向治疗在内的联合局部区域治疗，是为改善不可切除HCC患者的治疗效果而正在积极研究的一个课题。
已经开展了这些联合策略的各种临床试验；然而，这些研究的设计在治疗方式和方案、与对照组的比较、基线肿瘤分期和肝功能储备以及结局指标方面存在差异。
本文综述了联合局部区域和分子靶向治疗近期临床试验设计中的异质性，并简要探讨了未来的研究方向。
