Review of therapies for intermediate and advanced stage hepatocellular carcinoma, not suitable for curative therapies: a rapidly changing landscape

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dc.authorscopusid57217614267
dc.contributor.authorCarr B.I.
dc.date.accessioned2024-08-04T20:03:41Z
dc.date.available2024-08-04T20:03:41Z
dc.date.issued2019
dc.departmentİnönü Üniversitesien_US
dc.description.abstractRecent clinical trials and new agents have permitted greater clarity in the choice of effective agents for that majority of patients with hepatocellular carcinoma who have advanced disease at diagnosis and thus cannot be offered potentially curative resection, ablation or liver transplantation. The main treatment for these patients remains chemoembolization, although evidence for selective internal radiation therapy (SIRT) with SIR-Spheres or Theraphere, is beginning to suggest that the results with this may be comparable with less toxicity. Patients who have failed chemoembolization or SIRT or have metastatic disease at presentation are suitable for the multikinase inhibitor sorafenib (nexavar) or newly-approved lenvatinib (lenvima) as first line therapies. The choice between which of them to use first is not currently clear. Patients who have failed sorafenib can be offered a choice of FDA-approved regorafenib (stivarga) or immune checkpoint inhibitor nivolumab (opdivo) as second line agents. For that considerable percent of patients presenting with macroscopic portal vein thrombosis, the choice appears to be between multikinase inhibitor or SIRT, given the potential toxicity of chemoembolization in this setting. However, considering the potency of both nivolumab and regorafenib and the pipeline of new agents such as atezolizumab (tecentriq) in current clinical trials, including new immune checkpoint inhibitors, this landscape may change within a couple of years, especially if new evidence arises for the superior effectiveness of combinations of any of these agents over single agents. © The Author(s) 2019.en_US
dc.description.sponsorshipNational Institutes of Health, NIH: CA 82723en_US
dc.description.sponsorshipThis work was supported in part by NIH (CA 82723) to Carr BI.en_US
dc.identifier.doi10.20517/2394-5079.2018.113
dc.identifier.issn2394-5079
dc.identifier.scopus2-s2.0-85089883330en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.urihttps://doi.org/10.20517/2394-5079.2018.113
dc.identifier.urihttps://hdl.handle.net/11616/92014
dc.identifier.volume5en_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherOAE Publishing Inc.en_US
dc.relation.ispartofHepatoma Researchen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectadvanceden_US
dc.subjectHepatocellular carcinomaen_US
dc.subjectimmune checkpoint inhibitorsen_US
dc.subjectkinase inhibitorsen_US
dc.subjectselective internal radiation therapyen_US
dc.subjecttransarterial chemoembolizationen_US
dc.titleReview of therapies for intermediate and advanced stage hepatocellular carcinoma, not suitable for curative therapies: a rapidly changing landscapeen_US
dc.typeReview Articleen_US

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