Targeted agents for second-line treatment of advanced hepatocellular carcinoma

作     者：Nicola Personeni Tiziana Pressiani Silvia Bozzarelli Lorenza Rimassa 

作者机构：Medical Oncology and Hematology UnitHumanitas Cancer CenterHumanitas Clinical and Research CenterIRCCSRozzano 20089MilanItaly Department of Biomedical SciencesHumanitas UniversityPieve Emanuele 20090MilanItaly 

出 版 物：《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志（英文版）（电子版）)

年 卷 期：2019年第11卷第10期

页      面：788-803页

核心收录：

学科分类：10[医学] 

主　　题：Hepatocellular carcinoma Advanced-metastatic Second-line Third-line Regorafenib Cabozantinib Ramucirumab Angiogenesis Multikinase inhibitor MET AXL Vascular endothelial growth factor receptor 2 

摘      要：Over the past ten years,sorafenib,a multikinase inhibitor,has been the standard of care for patients with unresectable hepatocellular carcinoma(HCC)and wellpreserved liver ***,lenvatinib,a different multikinase inhibitor,was shown to be non-inferior to sorafenib,in terms of survival,while all other agents previously tested failed to prove non-inferiority(or superiority)when compared to ***,in the second-line setting,most investigational drugs failed to provide better survival outcomes than ***,in the last 2 years three positive phase III trials have been published in this *** RESORCE trial,a phase III study evaluating regorafenib in HCC patients who experienced disease progression after first-line treatment with sorafenib,showed better outcomes with regorafenib compared to *** recently,the phase III CELESTIAL trial demonstrated the superiority of cabozantinib,a multikinase inhibitor targeting vascular endothelial growth factor receptor,MET,and AXL,vs placebo in the second-and third-line setting in patients progressing on or intolerant to *** survival benefits of a sustained anti-angiogenic inhibition were demonstrated also with ramucirumab in the phase III REACH-2 trial in patients previously treated with sorafenib and who had high baseline alpha-fetoprotein ***,the adverse events reported in these trials were in line with the known safety profiles of the tested *** nearly a decade of a certain degree of stagnation,we are now witnessing a period of novel therapeutic advances with multikinase inhibitors and monoclonal antibodies that will likely change the treatment scenario of HCC.