Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning, China.
Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education; Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning, China.
Expert Opin Investig Drugs. 2022 Nov;31(11):1151-1167. doi: 10.1080/13543784.2022.2151891. Epub 2022 Nov 30.
Since the approval of sorafenib for systemic treatment of advanced hepatocellular carcinoma (HCC), many tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) have shown efficacy and tolerability as first-line treatments. On the other hand, these first-line therapies are associated with low objective response and drug resistance. Many drugs have been successfully tested for second-line treatment of advanced HCC. While the rapid proliferation of second-line treatments for advanced HCC brings hope to patients, it also complicates clinical decision-making.
This review aims to facilitate decisions by summarizing the latest guidelines for second-line treatment of HCC in various countries or regions. We then review existing second-line treatment options and discuss challenges that should be addressed in the future. A literature search was conducted in April 2022 of PubMed/Medline, Cochrane library, and abstracts of international cancer meetings.
There is no standard second-line treatment, especially for the case of sequential treatment after atezolizumab plus bevacizumab (atezo+bev) and further studies focused on sequential treatment are warranted in this setting. The design of clinical trials, different etiologies, and complications or quality of life (QoL) are interesting issues in the second-line setting.
索拉非尼获批用于晚期肝细胞癌（HCC）的系统治疗后，许多酪氨酸激酶抑制剂（TKI）和免疫检查点抑制剂（ICI）已被证明作为一线治疗具有疗效和耐受性。另一方面，这些一线疗法与低客观缓解率和耐药性相关。许多药物已成功用于晚期 HCC 的二线治疗。虽然晚期 HCC 的二线治疗方法迅速增多为患者带来了希望，但也使临床决策变得复杂。
本综述旨在通过总结各国或地区 HCC 二线治疗的最新指南来帮助决策。然后，我们回顾了现有的二线治疗选择，并讨论了未来需要解决的挑战。于 2022 年 4 月在 PubMed/Medline、 Cochrane 图书馆和国际癌症会议摘要中进行了文献检索。
没有标准的二线治疗，特别是在阿替利珠单抗联合贝伐珠单抗（atezo+bev）序贯治疗之后的情况下，在这种情况下需要进一步研究序贯治疗。临床试验的设计、不同的病因以及并发症或生活质量（QoL）是二线治疗中的有趣问题。
