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An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
Published on: September 12, 2019
Novel systemic therapy for hepatocellular carcinoma
Yawen Dong1, Tsung-Hao Liu2,3, Thomas Yau4
1Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
Abstract:
Systemic therapy for hepatocellular carcinoma (HCC) used to be limited to patients with advanced diseases and multi-kinase inhibitors targeting tumor angiogenesis the major approach of developing new treatment options. In the past 3 years, new data from trials of both molecular targeted therapy and immune checkpoint inhibitors (ICI) provided many new options of first- and second-line treatment for advanced HCC. Most notably, combination of ICI targeting the program cell death-1 (PD-1) pathway with other novel agents or conventional anti-cancer therapy may further improve treatment efficacy in different clinical settings. In this paper updated data of clinical trials of systemic therapy in the first- and second-line settings for advanced HCC were reviewed and the following issues were discussed: (1) lessons of trial design learned from positive and negative trials; (2) the balance between efficacy and safety in clinical practice; and (3) impact on future multi-disciplinary management of HCC.
Insights
New systemic therapies, including immune checkpoint inhibitors (ICI) and targeted treatments, offer advanced hepatocellular carcinoma (HCC) patients more options. Combinations of ICI targeting the program cell death-1 (PD-1) pathway show promise for improved efficacy.
Area of Science:
- Hepatobiliary Oncology
- Medical Oncology
- Clinical Trial Design
Background:
- Systemic therapy for advanced hepatocellular carcinoma (HCC) historically relied on multi-kinase inhibitors targeting tumor angiogenesis.
- Recent advancements have introduced molecular targeted therapies and immune checkpoint inhibitors (ICI) as viable treatment options.
Purpose of the Study:
- To review updated clinical trial data for first- and second-line systemic therapy in advanced HCC.
- To discuss key issues including trial design lessons, efficacy-safety balance, and impact on multidisciplinary management.
Main Methods:
- Review of updated clinical trial data for advanced HCC.
- Analysis of trial design, efficacy, safety, and clinical implications.
Main Results:
- Significant expansion of first- and second-line treatment options for advanced HCC.
- Emerging efficacy of immune checkpoint inhibitors (ICI), particularly in combination therapies.
- Combination of ICI targeting the program cell death-1 (PD-1) pathway shows potential for enhanced treatment outcomes.
Conclusions:
- Advanced HCC treatment landscape has evolved with new molecular targeted therapies and ICIs.
- Combination strategies, especially involving PD-1 pathway inhibitors, may improve treatment efficacy.
- Ongoing evaluation of trial design, efficacy, safety, and integration into multidisciplinary care is crucial.
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