Toxicity Profiles of Systemic Therapies for Advanced Hepatocellular Carcinoma

Griffiths, Christopher; Zhang, Betty; Tywonek, Kasia; Meyers, Brandon M.; Serrano, Pablo E.

doi:10.1001/jamanetworkopen.2022.22721

Cited by 11 publications

(8 citation statements)

References 65 publications

(448 reference statements)

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“…In summary, treatment beyond progression with ICIs may benefit a subset of patients with HCC due to the potential for later-onset tumor responses or disease stability. Given that treatment beyond progression may delay the use of subsequent line therapies, including oral kinase inhibitors which are associated with a less tolerable toxicity profile, treatment beyond progression with ICIs represents a promising avenue for maximizing treatment benefit in patients with HCC ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Treatment Beyond Progression After Anti-PD-1 Blockade in Hepatocellular Carcinoma

Lim,

Muquith,

Miramontes

et al. 2023

Cancer Research Communications

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Immune checkpoint inhibitors can induce atypical tumor responses including pseudo-progression in a subset of patients who may benefit from treatment beyond progression. While immune checkpoint inhibitors have emerged as frontline treatments for hepatocellular carcinoma and are associated with clinical benefit in a minority of patients, it is unclear whether treatment beyond progression has utility in this disease type. In a multicenter cohort analysis, treatment beyond progression was associated with no new safety signals, objective responses in 4.9% of patients, and disease control in 39% of patients. Progression-free survival and overall survival were comparable between patients treated beyond progression and patients treated with subsequent therapies, demonstrating that treatment beyond progression was not detrimental to survival outcomes. Rather, treatment beyond progression may benefit select patients with HCC and could represent a viable strategy for maximizing treatment benefit in these patients.

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Section: Discussionmentioning

confidence: 99%

Treatment Beyond Progression After Anti-PD-1 Blockade in Hepatocellular Carcinoma

Lim,

Muquith,

Miramontes

et al. 2023

Cancer Research Communications

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“…Delivering NPs loaded with VEGF-targeted drugs to tumor tissues via TACE can suppress the neovascularization of tumor tissues [17]. Systemic therapy in HCC is usually accompanied by systemic toxicity and severe side effects [18], and the application of NPs could remarkably increase local drug concentration, enhance the curative effects and reduce the side effects [19].…”

Section: Advantages Of Nps In Hcc Managementmentioning

confidence: 99%

Recent advances in hepatocellular carcinoma-targeted nanoparticles

Liu,

Bai,

Zhou

et al. 2024

Biomed. Mater.

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In the field of medicine, we often brave the unknown like interstellar explorers, especially when confronting the formidable opponent of hepatocellular carcinoma (HCC). The global burden of HCC remains significant, with suboptimal treatment outcomes necessitating the urgent development of novel drugs and treatments. While various treatments for liver cancer, such as immunotherapy and targeted therapy, have emerged in recent years, improving their transport and therapeutic efficiency, controlling their targeting and release, and mitigating their adverse effects remains challenging. However, just as we grope through the darkness, a glimmer of light emerges - nanotechnology. Recently, nanotechnology has attracted attention because it can increase the local drug concentration in tumors, reduce systemic toxicity, and has the potential to enhance the effectiveness of precision therapy for HCC. However, there are also some challenges hindering the clinical translation of drug-loaded nanoparticles (NPs). Just as interstellar explorers must overcome interstellar dust, we too must overcome various obstacles. In future researches, the design and development of nanodelivery systems for novel drugs treating HCC should be the first attention. Moreover, researchers should focus on the active targeting design of various NPs. The combination of the interventional therapies and drug-loaded NPs will greatly advance the process of precision HCC therapy.

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“…Superior efficacy profile notwithstanding, ICI therapy can impact and create an imbalance in the immune system that can result in a wide range of immune‐related adverse events, which are generally manageable but occasionally can be life‐threatening. A meta‐analysis that summarized the current evidence on toxicity profiles of TKIs and ICIs among patients with HCC, found serious adverse events to be lower with ICIs than with TKIs, while liver toxic effects were similar 127 …”

Section: Overview Of Current Management Strategies Of Hcc In Mena Regionmentioning

confidence: 99%

“…A metaanalysis that summarized the current evidence on toxicity profiles of TKIs and ICIs among patients with HCC, found serious adverse events to be lower with ICIs than with TKIs, while liver toxic effects were similar. 127 The cost of ICIs is a limiting factor for their use in the MENA region and since TKIs are covered by most governments, majority of patients choose this option.…”

Section: Transarterial Radioembolization (Tare)mentioning

confidence: 99%

Multidisciplinary consensus recommendations for management of hepatocellular carcinoma in Middle East and North Africa region

Waked,

Alsammany,

Tirmazy

et al. 2023

Liver International

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Hepatocellular carcinoma (HCC) is a growing health concern projected to cross over a million cases worldwide by 2025. HCC presents a significant burden of disease in Middle East and North African (MENA) countries due to a high prevalence of risk factors such as hepatitis C and B infections and rising incidence of non‐alcoholic steatohepatitis and non‐alcoholic fatty liver disease. In August 2022, an advisory meeting consisting of experts from 5 MENA countries was convened in an attempt to provide consensus recommendations on HCC screening, early diagnosis, current treatment modalities and unmet medical needs in the region. Data were collected from a pre‐meeting survey questionnaire and responses analysed and presented during the advisory meeting. This review summarizes the evidence discussed at the meeting and provides expert recommendations on the management of HCC. The 2022 update of Barcelona clinic liver cancer (BCLC) staging and treatment strategy and its implementation in the MENA region was extensively discussed. A key consensus of the expert panel was that multidisciplinary care is crucial to effective patient management that results in better clinical outcomes and overall survival of the patient. The panel recommended the use of predictive and early response biomarkers to guide clinicians in arriving at more effective therapeutic decisions. The experts also emphasized the role of robust screening/surveillance systems, population‐based registries, effective referral pathways and standardization of guidelines to ensure the successful management of HCC in the region.

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Toxicity Profiles of Systemic Therapies for Advanced Hepatocellular Carcinoma

Cited by 11 publications

References 65 publications

Treatment Beyond Progression After Anti-PD-1 Blockade in Hepatocellular Carcinoma

Treatment Beyond Progression After Anti-PD-1 Blockade in Hepatocellular Carcinoma

Recent advances in hepatocellular carcinoma-targeted nanoparticles

Multidisciplinary consensus recommendations for management of hepatocellular carcinoma in Middle East and North Africa region

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