The Current Landscape of Systemic Therapies for Advanced Hepatocellular Carcinoma
Purpose of review
As the global burden of HCC continues to rise, there is an overwhelming need for new systemic therapies for the treatment of advanced-stage HCC. In this review, we explore the current landscape of approved therapies for intermediate-stage HCC after progression with locoregional therapy or in those who present with advanced-stage HCC not amenable to curative options.
In the last 10 years, several agents have been studied in the first and second-line treatment of HCC but failed to show clinical benefit. Between 2008 and 2016, sorafenib was the sole agent used in the treatment of advanced-stage HCC. Recent strides have shown success with lenvatinib as an alternative agent for first-line treatment, and regorafenib, cabozantinib, ramucirumab, nivolumab, and pembrolizumab as second- and thrid-line agents in advanced HCC.
The next series of HCC trials are appropriately directed at combination therapies—combining targeted therapy with immunomodulators in the hopes of improving overall survival and ultimately getting closer to finding a cure.
Key WordsHepatocellular carcinoma Liver cancer Advanced therapy Systemic therapy
Compliance with ethical standards
Conflict of Interest
Prachi Rana and John Heydak each declare no conflicts of interest.
Anjana Pillai is on the speaker’s bureau for Eisai and Simply Speaking Hepatitis and served on speaker’s bureau for BTG. She is on the medical advisory board for Wako Diagnostics.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the author
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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