Management of advanced hepatocellular carcinoma in the era of targeted therapy.

摘要: Systemic chemotherapy has had a disappointing track record in the management of advanced hepatocellular carcinoma (HCC). Single-agent doxorubicin produces response rate 10–15%, but without any survival benefit, and combination also yielded unimpressive results. With recent advances knowledge hepato-carcinogenesis, there been encouraging development systemic therapy HCC patients, particularly targeted HCC. Among newly identified targets, exciting results have shown targeting anti-angiogenic pathway Raf/mitogen-activated protein kinase pathways. Bevacizumab, both as single agent with other agents, initial activity treating More recently, single-agent sorafenib, putative multitargeted inhibitor, to prolong overall patients pivotal phase III Sorafenib Assessment Randomized Protocol (SHARP) Oriental study. Currently, sorafenib is only approved for In addition, however, promising early reported molecular-targeted drugs including erlotinib sunitinib. Future progress seems likely depend on using controlled clinical trials optimize synergistic treatments.