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Advances in pharmacotherapeutics for hepatocellular carcinoma

Lucia Cerrito1, Francesco Santopaolo1, Flavia Monti

  • 1Internal Medicine, Gastroenterology And Hepatology, Fondazione Policlinico Universitario Agostino Gemelli Irccs, Università Cattolica Del Sacro Cuore, ROMA, ITALY.

Expert Opinion on Pharmacotherapy
|February 27, 2021
PubMed
Abstract

Insights

New targeted therapies and immune checkpoint inhibitors are expanding treatment options for advanced hepatocellular carcinoma (HCC). Lenvatinib offers a new first-line choice, while second-line treatments show promise for non-responders.

Area of Science:

  • Hepatocellular Carcinoma (HCC) Research
  • Oncology
  • Pharmacotherapy

Background:

  • Hepatocellular carcinoma (HCC) is the most common primary liver cancer with limited advanced-stage treatment options.
  • Sorafenib, a tyrosine-kinase inhibitor (TKI), was the sole effective systemic treatment for unresectable HCC for ten years.
  • Recent advancements have introduced new therapeutic possibilities for HCC management.

Purpose of the Study:

  • To review recent advancements in pharmacotherapy for HCC.
  • To discuss mechanisms of action, clinical efficacy, and safety of current HCC treatments.
  • To analyze the role of immune checkpoint inhibitors (ICIs) in HCC therapy.

Main Methods:

  • Analysis of recent literature on HCC pharmacotherapy.
  • Discussion of first-, second-, and third-line treatment options.
  • Evaluation of data on immune system modulators, including ICIs.

Main Results:

  • Lenvatinib represents a significant advancement in HCC therapy, altering first-line treatment selection criteria.
  • Sorafenib remains a well-documented option with extensive real-world data.
  • Second-line therapies are effective in patients who do not respond to or tolerate sorafenib.

Conclusions:

  • Treatment decisions for HCC should consider tumor characteristics, response rates, and adverse events.
  • Further comparative studies are needed for second-line agents like regorafenib, ramucirumab, and cabozantinib.
  • The therapeutic landscape for advanced HCC is rapidly evolving with new targeted and immune-based therapies.
Keywords:
Hepatocellular carcinomaimmune checkpoint inhibitorsmonoclonal antibodytyrosine-kinase inhibitorunresectable

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