Department of Medical Oncology, Centro di Riferimento Oncologico, Istituto Nazionale Tumori "CRO", IRCCS Aviano (PN), Italy.
Eur Rev Med Pharmacol Sci. 2019 Nov;23(22):10139-10150. doi: 10.26355/eurrev_201911_19584.
The curative hepatocellular carcinoma (HCC) therapy was traditionally based on surgical or loco-regional ablation approach. However, HCC is a solid tumor characterized by a highest level of vascularization; therefore, angiogenesis inhibitor could play a pivotal role in the pharmacological therapeutic approach. Despite the low number of approved drugs, a wide range of multi-kinase and MET inhibitor is currently being evaluated in phase II and III study. In this review, we described all the drugs that have shown efficacy in recently and ongoing trials. Moreover, the immunotherapy represents a recent challenge in the HCC treatment. The strategy based on the production of multi-epitope, multi-HLA peptide vaccine naturally processed and presented on primary tumor tissues of HCC patients. A further upgrade of cancer vaccine could be represented by the combination of metronomic chemotherapy and checkpoint inhibitors.
传统上,治疗肝癌(HCC)的方法是基于手术或局部消融方法。然而,HCC 是一种以最高血管化水平为特征的实体肿瘤;因此,血管生成抑制剂可能在药物治疗方法中发挥关键作用。尽管获得批准的药物数量很少,但目前正在进行 II 期和 III 期研究,评估多种多激酶和 MET 抑制剂。在这篇综述中,我们描述了最近和正在进行的试验中显示出疗效的所有药物。此外,免疫疗法是 HCC 治疗的一个新挑战。基于多表位、多 HLA 肽疫苗的策略,这些疫苗自然地在 HCC 患者的原发性肿瘤组织中加工和呈递。癌症疫苗的进一步升级可以通过节拍化疗和检查点抑制剂的联合来实现。