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Article

Drug Treatment for Advanced Hepatocellular Carcinoma: First-Line and Beyond

1
Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
2
Department of Oncology, Princess Margaret Hospital, Hong Kong, China
3
State Key Laboratory of Translational Oncology, Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2022, 29(8), 5489-5507; https://doi.org/10.3390/curroncol29080434
Received: 13 June 2022 / Revised: 29 July 2022 / Accepted: 2 August 2022 / Published: 4 August 2022
(This article belongs to the Special Issue New Insights of Liver Cancer and Its Treatment)
Hepatocellular carcinoma (HCC) has high mortality. The option of systemic therapy has increased significantly over the past five years. Sorafenib was the first multikinase inhibitor, introduced in 2007, as a treatment option for HCC, and it was the only effective systemic treatment for more than ten years. It was not until 2017 that several breakthroughs were made in the development of systemic strategies. Lenvatinib, another multikinase inhibitor, stood out successfully after sorafenib, and has been applied to clinical use in the first-line setting. Other multikinase inhibitors such as regorafenib, ramucirumab and cabozantinib, were approved in quick succession as second-line therapies. Concurrently, immune checkpoint inhibitors (ICIs) have readily become established treatments for many solid tumors, including HCC. The most studied ICIs to date, target programmed cell death-1 (PD-1), its ligand PD-L1, and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). These ICIs have demonstrated efficacy in treating advanced HCC. More recently, combination of bevacizumab and atezolizumab (ICI targeting PD-L1) was approved as the gold-standard first-line therapy. Combination of ICIs with nivolumab and ipilimumab was also approved in the second-line setting for those who failed sorafenib. At the moment, numerous clinical trials in advanced HCC are underway, which will bring continuous change to the management, and increase the survival, for patients with advanced HCC. Our review article: (1) summarizes United States Food and Drug Administration (US FDA) approved systemic therapies in advanced HCC, (2) reports the evidence of currently approved treatments, (3) discusses potential drugs/drug combinations being currently tested in phase III clinical trials, and (4) proposes possible future directions in drug development for advanced HCC. View Full-Text
Keywords: advanced hepatocellular carcinoma; systemic therapies; multikinase inhibitors; immunotherapy advanced hepatocellular carcinoma; systemic therapies; multikinase inhibitors; immunotherapy
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MDPI and ACS Style

Feng, M.Y.; Chan, L.L.; Chan, S.L. Drug Treatment for Advanced Hepatocellular Carcinoma: First-Line and Beyond. Curr. Oncol. 2022, 29, 5489-5507. https://doi.org/10.3390/curroncol29080434

AMA Style

Feng MY, Chan LL, Chan SL. Drug Treatment for Advanced Hepatocellular Carcinoma: First-Line and Beyond. Current Oncology. 2022; 29(8):5489-5507. https://doi.org/10.3390/curroncol29080434

Chicago/Turabian Style

Feng, Maple Ye, Landon L. Chan, and Stephen Lam Chan. 2022. "Drug Treatment for Advanced Hepatocellular Carcinoma: First-Line and Beyond" Current Oncology 29, no. 8: 5489-5507. https://doi.org/10.3390/curroncol29080434

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