Maida Marcello, Iavarone Massimo, Raineri Maurizio, Cammà Calogero, Cabibbo Giuseppe
Marcello Maida, Calogero Cammà, Giuseppe Cabibbo, Section of Gastroenterology, DIBIMIS, University of Palermo, 90127 Palermo, Italy.
World J Hepatol. 2015 Aug 18;7(17):2053-7. doi: 10.4254/wjh.v7.i17.2053.
Hepatocellular carcinoma (HCC) is the main cause of death in patients with cirrhosis, with an increasing incidence worldwide. Sorafenib is the choice therapy for advanced HCC. Over time several randomized phase III trials have been performed testing sunitinib, brivanib, linifanib and other molecules in head-to-head comparison with Sorafenib as first-line treatment for advanced-stage HCC, but none of these has so far been registered in this setting. Moreover, another feared vacuum arises from the absence of molecules registered as second-line therapy for patients who have failed Sorafenib, representing an urgent unmet medical need. To date all molecules tested as second-line therapies for advanced hepatocellular carcinoma, failed to demonstrate an increased survival compared to placebo. What are the possible reasons for the failure? What we should expect in the near future?
肝细胞癌（HCC）是肝硬化患者的主要死因，在全球范围内其发病率呈上升趋势。索拉非尼是晚期HCC的首选治疗药物。随着时间的推移，已经进行了几项随机III期试验，将舒尼替尼、布立尼布、林尼法尼和其他分子与索拉非尼进行头对头比较，作为晚期HCC的一线治疗，但迄今为止，这些药物在这种情况下均未获批。此外，另一个令人担忧的空白是，对于索拉非尼治疗失败的患者，缺乏获批的二线治疗药物，这代表着一项迫切未得到满足的医疗需求。迄今为止，所有作为晚期肝细胞癌二线治疗进行测试的分子，与安慰剂相比均未显示出生存期延长。失败的可能原因是什么？在不久的将来我们应该期待什么？
