2020
DOI: 10.1111/liv.14533
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Navigating the new landscape of second‐line treatment in advanced hepatocellular carcinoma

Abstract: Sorafenib and lenvatinib are approved for first-line treatment of patients with advanced hepatocellular carcinoma (HCC), and the efficacy of atezolizumab plus bevacizumab has been demonstrated versus sorafenib. Over time, first-line treatment frequently fails, and regorafenib, cabozantinib, ramucirumab (for patients with alpha fetoprotein ≥400 ng/mL), nivolumab, pembrolizumab and ipilimumab plus nivolumab are approved for use after sorafenib (but not lenvatinib) treatment in advanced HCC. Given the considerabl… Show more

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Cited by 35 publications
(37 citation statements)
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“…Although sorafenib and other immunosuppressants have the potential to improve prognosis, the two–five-month survival rate is still poor, which is far lower than that achieved for many other solid tumor types. 30 , 31 Therefore, there is an urgent need to find novel effective drugs for the treatment of HCC. Numerous natural bioactive compounds have attracted interest as complementary and alternative medicines as well as for cancer chemoprevention because of their fewer adverse reactions and some special therapeutic effects.…”
Section: Discussionmentioning
confidence: 99%
“…Although sorafenib and other immunosuppressants have the potential to improve prognosis, the two–five-month survival rate is still poor, which is far lower than that achieved for many other solid tumor types. 30 , 31 Therefore, there is an urgent need to find novel effective drugs for the treatment of HCC. Numerous natural bioactive compounds have attracted interest as complementary and alternative medicines as well as for cancer chemoprevention because of their fewer adverse reactions and some special therapeutic effects.…”
Section: Discussionmentioning
confidence: 99%
“…and Wörns discuss the complexity of second-line systemic therapies landscape for HCC. 3 After sorafenib-based therapy, cabozantinib, regorafenib and ramucirumab improved patients outcomes in well-designed phase III trials. [4][5][6] However, it is not yet defined whether these agents perform the same after lenvatinib, which was proven to be non-inferior to sorafenib and is largely available.…”
Section: Within This Context In This Issue Of Liver International Rmentioning
confidence: 99%
“…Alejandro Forner 2,3 F I G U R E 1 Proposed algorithm based on published phase III trials and subanalysis of the pivotal agents used for advanced hepatocellular carcinoma. AFP, alpha-foetoprotein; CP, Child-Pugh; ECOG-PS, Eastern Cooperative Oncology Group performance status; IO, immunooncology; miRNA, micro-RNAs; PVT, portal vein thrombosis.…”
Section: Leonardo G Da Fonsecamentioning
confidence: 99%
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“…In this rapidly evolving scenario, it is extremely important that physicians are updated and aware of novel therapeutic options in order to make the best use of them in various clinical settings [ 19 , 20 ].…”
mentioning
confidence: 99%