a Hepatobiliary and Pancreatic Oncology Division , National Cancer Center Hospital , Tokyo , Japan.
b Department of Developmental Therapeutics , National Cancer Center Hospital , Tokyo , Japan.
Expert Opin Pharmacother. 2018 Jun;19(9):993-1001. doi: 10.1080/14656566.2018.1479398. Epub 2018 Jun 18.
Many clinical trials have been conducted with chemotherapies in patients with advanced hepatocellular carcinoma (HCC). However, few agents have shown efficacy. It is thought that the efficacy of some agents might have resulted from the heterogeneity of tumors, insufficient dosages due to liver cirrhosis, and post-therapy effects. In recent years, immune checkpoint inhibitors have shown promising clinical activity and safety in patients with advanced HCC.
The authors provide an overview of chemotherapies used for the treatment of HCC, including ongoing trials. The authors also provide their expert opinion on the subject area and provide their future perspectives.
Based on favorable phase III clinical trial data, sorafenib and lenvatinib are considered promising agents for HCC as first-line systemic chemotherapy. Moreover, regorafenib and cabozantinib are useful second-line therapies after the failure of sorafenib. Furthermore, in early phase clinical trials, immune checkpoint inhibitors and the combinations of these inhibitors and molecular targeted agents have demonstrated promising activity. Therefore, better survival results are expected from future phase III clinical trials.
许多临床试验已经在晚期肝细胞癌（HCC）患者中进行了化疗。然而，很少有药物显示出疗效。人们认为，一些药物的疗效可能是由于肿瘤的异质性、肝硬化导致的剂量不足以及治疗后的影响。近年来，免疫检查点抑制剂在晚期 HCC 患者中显示出有希望的临床活性和安全性。
作者提供了用于治疗 HCC 的化疗药物概述，包括正在进行的试验。作者还就该主题领域提供了他们的专家意见，并提供了他们的未来展望。
基于有利的 III 期临床试验数据，索拉非尼和仑伐替尼被认为是 HCC 的有前途的一线系统化疗药物。此外，regorafenib 和 cabozantinib 是索拉非尼治疗失败后的二线有效治疗药物。此外，在早期临床试验中，免疫检查点抑制剂以及这些抑制剂与分子靶向药物的联合应用显示出了有希望的活性。因此，未来的 III 期临床试验有望获得更好的生存结果。
