Zhu Xiao-Dong, Tang Zhao-You, Sun Hui-Chuan
Department of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Genes Dis. 2020 Apr 7;7(3):328-335. doi: 10.1016/j.gendis.2020.03.010. eCollection 2020 Sep.
Liver cancer, mostly hepatocellular carcinoma (HCC), is the second leading cause of cancer mortality globally. Most patients were diagnosed at an advanced stage, and systemic therapy is the standard of care. All the approved systemic therapies for HCC are molecular targeted therapies with anti-angiogenic effects targeting the vascular endothelial growth factor signaling pathway. Sorafenib and lenvatinib are the first-line treatment, and regorafenib, ramucirumab, and cabozantinib are second-line treatment options. Although anti-PD-1 antibodies, including nivolumab and pembrolizumab, demonstrated promising anti-tumor effects as monotherapy for advanced HCC in phase II clinical trials, both failed in phase III studies. Anti-angiogenic treatment remains the backbone of systemic therapy for HCC. In this review, we summarized the approved anti-angiogenic medicines and discussed the potential strategies to improve the efficacy of anti-angiogenic therapy, including combination therapy with other treatments, and discussed the approaches to overcome the drawbacks of anti-angiogenic therapies.
肝癌，主要是肝细胞癌（HCC），是全球癌症死亡的第二大主要原因。大多数患者在晚期被诊断出来，全身治疗是标准治疗方法。所有已获批的HCC全身治疗方法都是针对血管内皮生长因子信号通路的具有抗血管生成作用的分子靶向疗法。索拉非尼和仑伐替尼是一线治疗药物，瑞戈非尼、雷莫西尤单抗和卡博替尼是二线治疗选择。尽管包括纳武单抗和帕博利珠单抗在内的抗PD-1抗体在II期临床试验中作为晚期HCC的单药治疗显示出有前景的抗肿瘤效果，但两者在III期研究中均失败。抗血管生成治疗仍然是HCC全身治疗的支柱。在本综述中，我们总结了已获批的抗血管生成药物，并讨论了提高抗血管生成治疗疗效的潜在策略，包括与其他治疗的联合治疗，并讨论了克服抗血管生成疗法缺点的方法。
