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肝细胞癌抗血管生成治疗的临床试验

Clinical trials of antiangiogenic therapy for hepatocellular carcinoma.

作者信息

Taketomi Akinobu

机构信息

Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan.

出版信息

Int J Clin Oncol. 2016 Apr;21(2):213-218. doi: 10.1007/s10147-016-0966-0. Epub 2016 Feb 22.

Abstract

Angiogenesis is a promising therapeutic target to inhibit tumor growth. This review summarizes data from clinical trials of antiangiogenic agents in hepatocellular carcinoma. A systematic search of PubMed was performed to identify clinical trials of specific antiangiogenic agents in hepatocellular carcinoma treatment, particularly phase III trials involving treatment guidelines for advanced hepatocellular carcinoma. Sorafenib is the only systemic drug approved for the treatment of advanced hepatocellular carcinoma. Two large-scale, randomized phase III trials using sorafenib involving patients with unresectable HCC showed a significant survival benefit compared with placebo control groups. However, subsequent phase III trials of antiangiogenic agents in hepatocellular carcinoma have failed to improve survival compared with standard treatment protocols using sorafenib. The efficacy of antiangiogenic agents in combination with other drugs, transarterial chemoembolization, and surgical resection is currently being investigated. Future research is expected to optimize antiangiogenic therapies in combination with standard treatment with sorafenib.

摘要

血管生成是抑制肿瘤生长的一个有前景的治疗靶点。本综述总结了抗血管生成药物治疗肝细胞癌的临床试验数据。通过对PubMed进行系统检索,以确定抗血管生成药物治疗肝细胞癌的临床试验,特别是涉及晚期肝细胞癌治疗指南的III期试验。索拉非尼是唯一被批准用于治疗晚期肝细胞癌的全身用药。两项使用索拉非尼的大规模、随机III期试验纳入了不可切除肝癌患者,结果显示与安慰剂对照组相比有显著的生存获益。然而,随后肝细胞癌抗血管生成药物的III期试验与使用索拉非尼的标准治疗方案相比未能提高生存率。目前正在研究抗血管生成药物与其他药物、经动脉化疗栓塞和手术切除联合使用的疗效。未来的研究有望优化抗血管生成疗法与索拉非尼标准治疗的联合应用。

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