Emerging agents and regimens for hepatocellular carcinoma

Area of Science:

• Hepatology
• Medical Oncology
• Cancer Research

Background:

• Hepatocellular carcinoma (HCC) is a major global cause of cancer mortality.
• Systemic therapies are crucial for managing HCC at various treatment stages.
• Sorafenib was the initial standard of care, but recent advancements offer new options.

Purpose of the Study:

• To review the evolution of systemic therapies for HCC.
• To highlight emerging treatment strategies, including immunotherapies and targeted agents.
• To discuss the potential of combination therapies in HCC management.

Main Methods:

• Review of clinical trials and treatment guidelines for HCC.
• Analysis of first-line and second-line systemic treatment options.
• Examination of novel therapeutic approaches like anti-PD-1 antibodies and anti-angiogenesis agents.

Main Results:

• Lenvatinib is an alternative first-line option; regorafenib, ramucirumab, and cabozantinib are second-line choices.
• Anti-PD-1 antibodies show efficacy as monotherapy in advanced HCC.
• Combinations of anti-PD-1 antibodies and anti-angiogenesis agents demonstrate enhanced anti-tumor activity.

Conclusions:

• The treatment landscape for advanced HCC is rapidly changing with new therapeutic agents.
• Combination therapies, particularly involving immunotherapy and anti-angiogenesis, are a key area of ongoing research.
• Investigating these agents in combination with surgery or loco-regional therapies may benefit early and intermediate-stage HCC patients.