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肝细胞癌治疗的最新进展。

Recent advances in hepatocellular carcinoma therapy.

作者信息

Dutta Rinku, Mahato Ram I

机构信息

Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, United States.

Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, United States.

出版信息

Pharmacol Ther. 2017 May;173:106-117. doi: 10.1016/j.pharmthera.2017.02.010. Epub 2017 Feb 5.

Abstract

Hepatocellular carcinoma (HCC), also called malignant hepatoma, is one of the deadliest cancers due to its complexities, reoccurrence after surgical resection, metastasis and heterogeneity. Incidence and mortality of HCC are increasing in Western countries and are expected to rise as a consequence of the obesity epidemic. Multiple factors trigger the initiation and progression of HCC including chronic alcohol consumption, viral hepatitis B and C infection, metabolic disorders and age. Although Sorafenib is the only FDA approved drug for the treatment of HCC, numerous treatment modalities such as transcatheter arterial chemoembolization/transarterial chemoembolization (TACE), radiotherapy, locoregional therapy and chemotherapy have been tested in the clinics. Polymeric nanoparticles, liposomes, and micelles carrying small molecules, proteins, peptides and nucleic acids have attracted great attention for the treatment of various cancers including HCC. Herein, we discuss the pathogenesis of HCC in relation to its various recent treatment methodologies using nanodelivery of monoclonal antibodies (mAbs), small molecules, miRNAs and peptides. Synopsis of recent clinical trials of mAbs and peptide drugs has been presented with a broad overview of the pathogenesis of the disease and treatment efficacy.

摘要

肝细胞癌(HCC),也称为恶性肝癌,因其复杂性、手术切除后复发、转移和异质性,是最致命的癌症之一。在西方国家,HCC的发病率和死亡率正在上升,预计随着肥胖症流行还会进一步增加。多种因素会引发HCC的发生和发展,包括长期饮酒、乙型和丙型病毒感染、代谢紊乱以及年龄。尽管索拉非尼是唯一经美国食品药品监督管理局(FDA)批准用于治疗HCC的药物,但许多治疗方式,如经动脉化疗栓塞术/经动脉化学栓塞术(TACE)、放射疗法、局部区域疗法和化疗,都已在临床上进行了试验。携带小分子、蛋白质、肽和核酸的聚合物纳米颗粒、脂质体和胶束在包括HCC在内的各种癌症治疗中引起了极大关注。在此,我们讨论HCC的发病机制及其使用单克隆抗体(mAb)、小分子、微小RNA(miRNA)和肽的纳米递送的各种最新治疗方法。本文介绍了mAb和肽药物近期临床试验的概要,并对该疾病的发病机制和治疗效果进行了广泛概述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/689b/5777523/55d212a07d35/nihms867338f1.jpg

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