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Published on: September 12, 2019
Current statuses of molecular targeted and immune checkpoint therapies in hepatocellular carcinoma
Deqiang Kong1, Chen Liu1, Xiaolong Miao1
1Department of Surgery, Second Affiliated Hospital of School of Medicine, Zhejiang University Hangzhou, People's Republic of China.
Abstract:
Treatment of advanced hepatocellular carcinoma (HCC) still confronts great challenges due to high rate of therapeutic resistance. The emergence of systemic treatment with molecular targeted and immune checkpoint therapies has brought novel approaches towards patients with advanced HCC. However, sorafenib, as the first approved systemic treatment in 2007, only increased overall survival by three months in advanced HCC patients. Afterwards, little progress has been made for molecular targeted agents. Only four molecular drugs are empirically used in clinical practice. Lenvatinib acts as a first-line drug, whereas regorafenib, ramucirumab, and cabozantinib are defined as second-line drugs. Nevertheless, clinical findings reveal that overall survival remains unchanged. Albeit immunotherapy-based approaches are currently considered promising therapeutic strategies for advanced HCC, a minority of patients could benefit from them. These beneficiaries are to be accordingly identified. Combined immunotherapies with matched molecular targeted treatments would be a novel breakthrough. Herein, we summarize the current statuses of immunotherapies and molecular targeted drug therapies, and mainly identify clinically feasible chemoimmunotherapeutic strategies.
Insights
Advanced hepatocellular carcinoma (HCC) treatment faces challenges. Combining molecular targeted therapies with immunotherapies may offer a breakthrough for patient benefit.
Area of Science:
- Hepatocellular Carcinoma Research
- Medical Oncology
- Immunotherapy
Background:
- Advanced hepatocellular carcinoma (HCC) treatment remains challenging due to significant therapeutic resistance.
- Current systemic treatments, including molecular targeted therapies, offer limited survival benefits.
- Immunotherapy shows promise but benefits only a subset of patients.
Purpose of the Study:
- To review the current landscape of immunotherapies and molecular targeted therapies for advanced HCC.
- To identify potential beneficiaries for immunotherapy.
- To explore clinically feasible chemoimmunotherapeutic strategies.
Main Methods:
- Literature review of systemic treatments for advanced HCC.
- Analysis of current molecular targeted agents and immunotherapies.
- Identification of combined treatment strategies.
Main Results:
- Sorafenib, the first systemic agent, provided only a modest survival increase.
- Limited progress in molecular targeted agents, with only four drugs in clinical use.
- Immunotherapy benefits a minority, necessitating identification of responders.
Conclusions:
- Combined immunotherapies with matched molecular targeted treatments represent a potential breakthrough.
- Identifying patients who can benefit from immunotherapy is crucial.
- Developing clinically feasible chemoimmunotherapeutic strategies is a key future direction.
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