Systemic Therapy for Hepatocellular Carcinoma: 2017 Update

Abstract

Systemic therapy for hepatocellular carcinoma (HCC) changed drastically after the introduction of the molecular targeted agent sorafenib in 2007. Sorafenib provides an additional therapeutic option for patients with extrahepatic spread or vascular invasion, resulting in improved survival even among patients with advanced HCC; however, the toxicity of sorafenib and its unsatisfactory antitumor effects remain unsolved issues. The development of novel molecular targeted agents as alternatives to sorafenib has been limited by difficulties unique to HCC. Recent studies have demonstrated the efficacy of two molecular targeted agents, the second-line agent regorafenib, which is used after sorafenib failure, and the first-line agent lenvatinib, which has been shown to be noninferior to sorafenib. Another category of agents that are attracting considerable interest are immune checkpoint inhibitors such as anti-PD-1/PD-L1 or CTLA-4 antibodies, which kill cancer cells via a unique mechanism. The therapeutic effects of some of these agents are currently under investigation in phase III studies. The most recent topics of interest are the combination of anti-PD-1/PD-L1 therapies with other immune checkpoint inhibitors, such as anti-CTLA-4 antibodies, or with a tyrosine kinase inhibitor, or with locoregional therapies such as resection, ablation, or transarterial chemoembolization.

The RNA‐binding protein SORBS2 suppresses hepatocellular carcinoma tumourigenesis and metastasis by stabilizing RORA mRNA

“…Hepatocellular carcinoma (HCC), the most common primary malignancy of the liver, ranks as the second leading cause of cancer mortality worldwide . Although significant improvements have been made in the early diagnosis, effective monitoring and more treatment options for HCC in the last two decades, the long‐term survival of HCC patients remains poor because of the high probability of recurrence and metastasis of HCC after surgical resection . Therefore, it is critical to explore the molecular mechanisms underlying the progression of HCC.…”

miR‐365 regulates liver cancer stem cells via RAC1 pathway

“…Hepatocellular carcinoma (HCC) is a worldwide and lethal cancer with high incidence and recurrence . Only a part of HCC patients benefit from TACE or sorafenib treatment . Most cancer therapies fail to eradicate tumors due to the existence of CSCs .…”

Genome-Wide Analysis of Prognostic lncRNAs, miRNAs, and mRNAs Forming a Competing Endogenous RNA Network in Hepatocellular Carcinoma

“…The process underlying the onset and progression of HCC is complex and involves many factors, but the precise molecular events that underlie the poor prognosis of HCC remain obscure. To date, the continuous advancement in medical technology, including liver transplantation, surgical resection, and radiofrequency ablation, is still unable to elevate the dismal 5-year survival rate of patients with HCC, which is lower than 20% [5,6]. The undesirable prognosis of HCC is largely due to limited knowledge of the molecular factors involved in HCC, which leads to the lack of effective interventions [7,8].…”