Personalized therapy for hepatocellular carcinoma: Where are we now?

Chan, Stephen L.; Wong, Alissa Michelle Go; Lee, Kirsty; Wong, Nathalie; Chan, Allen

doi:10.1016/j.ctrv.2016.02.008

Cited by 56 publications

(50 citation statements)

References 114 publications

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“…mTOR inhibitors have been already tested in clinical trials with sorafenib-refractory or intolerant patients with HCC without significant results. However, it is important to point out that a subgroup analysis of the second-line phase III Everolimus for Liver Cancer Evaluation clinical trial demonstrated significant benefits in HBV compared with HCV-infected patients with HCC (as reviewed in reference 4) 4. This clinical observation is consistent with the present findings of Ho et al and emphasises the significance of their study.…”

supporting

confidence: 89%

“…Sorafenib offers modest survival benefit, and recently some concerns about its cost-effectiveness have been raised 3. In the last years, many other molecular targeted agents have been tested for the treatment of HCC in different clinical trials with negative results 2 4…”

mentioning

confidence: 99%

“…HCV infection, alcohol abuse and obesity are the main aetiological causes of HCC in Western countries 4. However, HBV infection accounts for about 60% of the total liver cancer in the low and middle-income world, particularly in sub-Saharan Africa and Asia 2…”

mentioning

confidence: 99%

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Targeting the correct target in HCC

Berasain

Lechel

2017

Gut

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supporting

confidence: 89%

mentioning

confidence: 99%

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Targeting the correct target in HCC

Berasain

Lechel

2017

Gut

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“…However, in the era of molecular and personalized medicine, clinical needs for tissue acquisition before any treatment will be increased for genetic analysis to easily risk-stratify patients, identify dominant oncogenic pathways, and institute-targeted and curative therapies in the near future (1920). Thus, the amount of tissues needed for genetic analysis increases and requires more core tissues from biopsy.…”

Section: Discussionmentioning

confidence: 99%

New Radiofrequency Device to Reduce Bleeding after Core Needle Biopsy: Experimental Study in a Porcine Liver Model

et al. 2017

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ObjectiveTo evaluate the in vivo efficiency of the biopsy tract radiofrequency ablation for hemostasis after core biopsy of the liver in a porcine liver model, including situations with bleeding tendency and a larger (16-gauge) core needle.Materials and MethodsA preliminary study was performed using one pig to determine optimal ablation parameters. For the main experiment, four pigs were assigned to different groups according to heparinization use and biopsy needle caliber. In each pig, 14 control (without tract ablation) and 14 experimental (tract ablation) ultrasound-guided core biopsies were performed using either an 18- or 16-gauge needle. Post-biopsy bleeding amounts were measured by soaking up the blood for five minutes. The results were compared using the Mann-Whitney U test.ResultsThe optimal parameters for biopsy tract ablation were determined as a 2-cm active tip electrode set at 40-watt with a tip temperature of 70–80℃. The bleeding amounts in all experimental groups were smaller than those in the controls; however they were significant in the non-heparinized pig biopsied with an 18-gauge needle and in two heparinized pigs (p < 0.001). In the heparinized pigs, the mean blood loss in the experimental group was 3.5% and 13.5% of the controls biopsied with an 18- and 16-gauge needle, respectively.ConclusionRadiofrequency ablation of hepatic core biopsy tract ablation may reduce post-biopsy bleeding even under bleeding tendency and using a larger core needle, according to the result from in vivo porcine model experiments.

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“…Palliative treatments are represented by locoregional and systemic treatment strategies, but also individualized concepts that can combine different modalities (BCLC B/C). The decision regarding treatment should always aim to increase patients’ OS [5] by identification of the best personalized therapy concept [6] (Fig. 2).…”

Section: Treatment Of Hccmentioning

confidence: 99%

Novel implications in the treatment of hepatocellular carcinoma

Best

Schotten

Theysohn³

et al. 2016

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Worldwide hepatocellular carcinoma remains one of the leading causes of cancer-related death, associated with a poor prognosis due to late diagnosis in the majority of cases. Physicians at care are frequently confronted with patients who are ineligible for curative treatment such as liver resection, transplantation or radiofrequency ablation. Besides established palliative locoregional therapies, such as ablation or chemoembolization, new treatment options, such as microwave ablation, drug-eluting bead transarterial chemoembolization or selective internal radiation therapy, are emerging; however, data from randomized controlled trials are still lacking. In order to achieve optimal tumor control, patients should receive tailored treatment concepts, considering their tumor burden, liver function and performance status, instead of strictly assigning patients to treatment modalities following algorithms that may be partly very restrictive. Palliative locoregional pretreatment might facilitate downstaging to ensure later curative resection or transplantation. In addition, the combined utilization of different locoregional treatment options or systemic co-treatment has been the subject of several trials. In cases where local tumor control cannot be achieved, or in the scenario of extrahepatic spread, sorafenib remains the only approved systemic therapy option. Alternative targeted therapies, such as immune checkpoint inhibitors have shown encouraging preliminary results, while data from phase III studies are pending.

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Personalized therapy for hepatocellular carcinoma: Where are we now?

Cited by 56 publications

References 114 publications

Targeting the correct target in HCC

Targeting the correct target in HCC

New Radiofrequency Device to Reduce Bleeding after Core Needle Biopsy: Experimental Study in a Porcine Liver Model

Novel implications in the treatment of hepatocellular carcinoma

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