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Updated: Jun 25, 2026

An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
Published on: September 12, 2019
mTOR inhibitors for hepatocellular cancer: a forward-moving target
1Department of Internal Medicine, Zollernalb Clinic, Academic Teaching Hospital of Tuebingen University, Balingen, Germany. gt@helico.de
Abstract:
mTOR is a central regulator of cell growth and angiogenesis. The mTOR pathway is activated in 40-50% of patients with hepatocellular cancer (HCC). In different models (i.e., hepatoma cell lines and implanted HCC tumors in rats), mTOR inhibitors (mTORIs) were effective in reducing cell growth and tumor vascularity. Synergistic effects were observed for mTORIs and chemotherapeutic agents in these studies, while other combinations involving mTORIs and inhibitors of growth hormones and angiogenesis are awaiting further clinical testing. A number of mTORIs are already clinically available (e.g., sirolimus, temsirolimus and everolimus), sharing similiar pharmacokinetic parameters (except for absorption) and side effects. Clinical data are, as yet, only preliminary and are mainly derived from retrospective studies in patients who underwent liver transplantation for HCC. Those patients had received sirolimus thereafter for immunosuppression, and a much lower rate of tumor recurrence than with calcineurin inhibitors alone was noted. Current prospective trials for treatment of advanced HCC include mTORIs alone or in combination with either transarterial chemoembolization or other systemic drugs, and will be discussed in detail in this review.
Insights
mTOR inhibitors show promise in treating hepatocellular cancer (HCC) by reducing tumor growth and vascularity. Combinations with chemotherapy and findings in liver transplant patients suggest potential for advanced HCC treatment.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- The mammalian target of rapamycin (mTOR) pathway regulates cell growth and angiogenesis.
- mTOR pathway activation is observed in 40-50% of hepatocellular cancer (HCC) cases.
- mTOR inhibitors (mTORIs) demonstrate efficacy in preclinical HCC models.
Purpose of the Study:
- To review the role of mTOR inhibitors in hepatocellular cancer treatment.
- To discuss the efficacy of mTORIs alone and in combination therapies for HCC.
- To summarize current clinical data and ongoing trials involving mTORIs for advanced HCC.
Main Methods:
- Review of preclinical studies using hepatoma cell lines and rat HCC models.
- Analysis of available clinical data, primarily from retrospective studies in liver transplant recipients.
- Discussion of ongoing prospective clinical trials for advanced HCC treatment.
Main Results:
- mTORIs effectively reduced cell growth and tumor vascularity in preclinical HCC models.
- Synergistic effects were noted between mTORIs and chemotherapeutic agents.
- Retrospective data suggest lower HCC recurrence rates in liver transplant patients treated with sirolimus for immunosuppression compared to calcineurin inhibitors.
Conclusions:
- mTOR inhibitors represent a promising therapeutic strategy for HCC.
- Combination therapies involving mTORIs and other agents warrant further investigation.
- Ongoing clinical trials are crucial for establishing the role of mTORIs in advanced HCC management.
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