Hepatocellular Carcinoma: A Global Disease in Need of Individualized Treatment Strategies

Personeni, Nicola; Rimassa, Lorenza

doi:10.1200/jop.2017.024604

Cited by 16 publications

(13 citation statements)

References 10 publications

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“…HCC is a global disease, which more than others mirrors different regional etiologies, ethnicities,49 and treatment approaches 50. As a result, on a worldwide scale, a certain treatment may paradoxically yield discrepant outcomes, as previously shown, for instance, by the SHARP2 and the Asia-Pacific3 trials of sorafenib.…”

Section: Introductionmentioning

confidence: 99%

<p>Lenvatinib for the treatment of unresectable hepatocellular carcinoma: evidence to date</p>

Personeni

Pressiani

Rimassa

2019

JHC

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During the last 10 years, the multikinase inhibitor sorafenib has emerged as the only systemic treatment for unresectable hepatocellular carcinoma (HCC). More recently, data from the Phase III REFLECT trial showed that another multikinase inhibitor, namely, lenvatinib, was non-inferior to sorafenib in terms of overall survival (OS). In contrast, with respect to OS, previous randomized Phase III trials have been negative, and several agents tested have failed to prove non-inferiority (or superiority) when compared with sorafenib in a first-line setting. Furthermore, the REFLECT trial demonstrated that lenvatinib, in comparison with sorafenib, significantly increased progression-free survival, time to progression, and objective response rate. Overall, the incidence of grade ≥3 treatment-emergent adverse events (TEAEs) was similar in the two treatment arms of the trial, with a higher incidence of serious TEAEs in the lenvatinib arm. Encouraging efficacy signals had already been reported for immune checkpoint inhibitors in HCC, and different synergisms have been postulated in the frame of interplay between vascular endothelial growth factor receptor-2 inhibitors and immunotherapy. Given these premises, future approaches are being developed in Phase I trials testing lenvatinib in combination with pembrolizumab or nivolumab. As the treatment landscape of HCC is expanding with novel agents being approved for patients who are intolerant or are progressing on prior sorafenib, we will discuss current challenges pertaining to the optimal sequencing of active agents in first- and second-line setting.

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Section: Introductionmentioning

confidence: 99%

<p>Lenvatinib for the treatment of unresectable hepatocellular carcinoma: evidence to date</p>

Personeni

Pressiani

Rimassa

2019

JHC

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“…HCC typically develops in a background of underlying inflammatory liver disease, especially that associated with hepatitis B (HBV) or hepatitis C virus (HCV) infection ( 3 ), while nonalcoholic fatty liver disease (NAFLD) is rapidly becoming a key etiological factor for HCC in many Western countries ( 4 , 5 ). Current treatment modalities for patients with nonadvanced HCC include resection, transplantation, ablation, or chemoembolization, while patients with advanced HCC receive systemic treatment ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Biomarkers and Future Perspectives for Hepatocellular Carcinoma Immunotherapy

Che

et al. 2021

Front. Oncol.

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Hepatocellular cancer is the sixth most frequently diagnosed malignant disease worldwide, and was responsible for tens of millions of deaths in 2020; however, treatment options for patients with advanced hepatocellular carcinoma remain limited. Immunotherapy has undergone rapid development over recent years, especially in the field of immune checkpoint inhibitors (ICIs). These drugs aim to activate and enhance antitumor immunity and represent a new prospect for the treatment of patients with advanced cancer. Nevertheless, only a small proportion of liver cancer patients currently benefit from ICI-based treatment, highlighting the need to better understand how ICIs and tumors interact, as well as identify predictive biomarkers for immunotherapeutic responses. In this review, we highlight clinical trials and basic research in hepatocellular carcinoma, with a particular focus on predictive biomarkers for the therapeutic efficacy of ICIs. Predictive biomarkers for immune-related adverse events are also discussed.

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“…1 Although the principal treatment for HCC is surgical resection, some cases require treatments other than surgical resection such as radiofrequency ablation (RFA), hepatic arterial infusion chemotherapy (HAIC), transcatheter arterial chemoembolization (TACE), or molecular targeted drugs according to the status of tumor, hepatic reserve, and patient's performance status. 2 The up-to-seven criteria were initially developed by Mazzaferro and colleagues for patients who had undergone liver transplantation. 3 Because Barcelona Clinic Liver Cancer (BCLC)-B HCC comprises a heterogeneous population of patients with a wide range of tumor burdens, sub-classification of BCLC-B HCC using the up-to-seven criteria has recently been advocated.…”

Section: Introductionmentioning

confidence: 99%

“…2 /m 2 for males, 3.36 cm 2 /m 2 for females for HAIC/TACE or 5.66 cm 2 /m 2 for males, 4.61 cm 2 /m 2 for females for SOR/LEN). Patients received SOR 400 mg orally twice daily or LEN 12 mg orally once daily for those with a baseline body weight (BW) ≥60 kg and 8 mg with BW <60 kg.…”

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confidence: 97%

Combination of psoas muscle mass index and neutrophil/lymphocyte ratio as a prognostic predictor for patients undergoing nonsurgical hepatocellular carcinoma therapy

et al. 2021

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Background and Aim: Reliable predictors for hepatocellular carcinoma (HCC) are urgently needed. The psoas muscle index (PMI) is a simple and rapid method for evaluating muscle atrophy. Furthermore, the neutrophil/lymphocyte ratio (NLR) is a prognostic factor that is easy to calculate in everyday clinical practice. We aimed to investigate the value of the PMI and NLR as prognostic factors for patients receiving nonsurgical HCC therapy, hepatic arterial infusion chemotherapy (HAIC), transcatheter arterial chemoembolization (TACE), or molecular targeted drugs such as sorafenib (SOR) and lenvatinib (LEN). Methods: We enrolled 87 patients with HCC who were treated with HAIC, TACE, SOR, or LEN. The primary endpoint was overall survival (OS) with variable PMI or NLR status. For Barcelona Clinic Liver Cancer (BCLC)-B patients, useful prognostic factors were examined by comparing the OS between stratified groups. Prognostic factors including PMI and NLR were evaluated by univariate and multivariate analysis.Results: Analysis of HAIC or TACE (HAIC/TACE) and SOR or LEN (SOR/LEN) patients showed significant differences in OS between low and high PMI. In patients treated with TACE, there was a significant difference in OS between low and high NLR. For BCLC-B and low PMI, the prognosis was significantly worse for SOR/LEN than for TACE, although there was no difference for high PMI, suggesting that PMI may be useful for treatment selection. In addition, the prognostic formula composed of PMI, NLR, and up-to-seven criteria developed in the present study may be useful. Conclusion: PMI and NLR are considered to be independent prognostic factors for HCC.

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Hepatocellular Carcinoma: A Global Disease in Need of Individualized Treatment Strategies

Cited by 16 publications

References 10 publications

<p>Lenvatinib for the treatment of unresectable hepatocellular carcinoma: evidence to date</p>

<p>Lenvatinib for the treatment of unresectable hepatocellular carcinoma: evidence to date</p>

Biomarkers and Future Perspectives for Hepatocellular Carcinoma Immunotherapy

Combination of psoas muscle mass index and neutrophil/lymphocyte ratio as a prognostic predictor for patients undergoing nonsurgical hepatocellular carcinoma therapy

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