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Goals and targets for personalized therapy for HCC

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Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality worldwide and its incidence continues to rise. While cirrhosis underlies most cases of HCC, many molecular pathways are implicated in HCC carcinogenesis, including the TERT promoter mutation, Wnt/β-catenin, P53, Akt/mTOR, vascular endothelial growth factor receptor (VEGFR), and endothelial growth factor receptor (EGFR)/RAS/MAPK pathways. While the most widely used staging and treatment algorithm for HCC—the Barcelona Clinic Liver Cancer (BCLC) system—does not recommend systemic molecular therapy for early HCC, a variety of treatment options are available depending upon the stage of HCC at diagnosis. Determining the best treatment options must take into account not only the burden and extent of HCC, but also the patient’s performance status, underlying liver function, extra-hepatic disease and co-morbidities. Radiofrequency or microwave ablation, liver resection, or liver transplantation, all potential curative therapies for HCC, should be the first-line treatments when possible. For patients who are not candidates of curative treatments, locoregional therapies such as transarterial chemoembolization (TACE), transarterial radioembolization (TARE), and stereotactic body radiation (SBRT) can improve survival and quality of life. Sorafenib, a multi-kinase VEGF inhibitor, is the most widely used systemic chemotherapy approved as a first-line agent for unresectable or advanced HCC. Clinical trials are underway directed towards molecular therapies that target different aspects of the hepatocellular carcinogenesis cascade. Ideally, the goal of future therapy should be to target multiple pathways in the HCC cascade with combination treatments to achieve personalized care aimed at improving overall survival.

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References

  1. Grandhi MS, Kim AK, Ronnekleiv-Kelly SM, Kamel IR, Ghasebeh MA, Pawlik TM. Hepatocellular carcinoma: from diagnosis to treatment. Surg Oncol 2016;25(2):74–85

    Article  PubMed  Google Scholar 

  2. Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet 2012;379(9822):1245–1255

    Article  PubMed  Google Scholar 

  3. Zucman-Rossi J, Villanueva A, Nault JC, Llovet JM. Genetic landscape and biomarkers of hepatocellular carcinoma. Gastroenterology 2015;149(5):1226–1239

    Article  CAS  PubMed  Google Scholar 

  4. Calderaro J, et al. Histological subtypes of hepatocellular carcinoma are related to gene mutations and molecular tumour classification. J Hepatol 2017;67(4):727–738

    Article  CAS  PubMed  Google Scholar 

  5. Schulze K, et al. Exome sequencing of hepatocellular carcinomas identifies new mutational signatures and potential therapeutic targets. Nat Genet 2015;47(5):505–511

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Ally A, et al. Comprehensive and integrative genomic characterization of hepatocellular carcinoma. Cell 2017;169(7):1327–1341

    Article  CAS  Google Scholar 

  7. Villanueva A, Newell P, Chiang DY, Friedman SL, Llovet JM. Genomics and signaling pathways in hepatocellular carcinoma. Semin Liver Dis 2007;27(1):55–76

    Article  CAS  PubMed  Google Scholar 

  8. Schlachterman A, Craft WW, Hilgenfeldt E, Mitra A, Cabrera R. Current and future treatments for hepatocellular carcinoma. World J Gastroenterol 2015;21(28):8478–8491

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shin JW. Molecular targeted therapy for hepatocellular carcinoma: current and future. World J Gastroenterol 2013;19(37):6144

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Ma L, Chua MS, Andrisani O, So S. Epigenetics in hepatocellular carcinoma: an update and future therapy perspectives. World J Gastroenterol 2014;20(2):333–345

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Heimbach JK, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 2018;67(1):358–380

    Article  PubMed  Google Scholar 

  12. Omata M, et al. Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int 2017;11(4):317–370

    Article  PubMed  Google Scholar 

  13. Silva MA, Hegab B, Hyde C, Guo B, Buckels JAC, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut 2008;57(11):1592–1596

    Article  CAS  PubMed  Google Scholar 

  14. Guyatt GH, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Chin J Evid Based Med 2009;9(1):8–11

    Google Scholar 

  15. Sullivan RCCCRFBDNWAGBZMPEGS. Imaging techniques for the diagnosis of hepatocellular carcinoma a systematic review and meta-analysis. Ann Intern Med 2015;162:697–711

    Article  PubMed  Google Scholar 

  16. Furlan A, et al. Hepatocellular carcinoma in cirrhotic patients at multidetector CT: hepatic venous phase versus delayed phase for the detection of tumour washout. Br J Radiol 2011;84(1001):403–412

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Faria SC, Szklaruk J, Kaseb AO, Hassabo HM, Elsayes KM. TNM/Okuda/Barcelona/UNOS/CLIP international multidisciplinary classification of hepatocellular carcinoma: concepts, perspectives, and radiologic implications. Abdom Imaging 2014;39(5):1070–1087

    Article  PubMed  Google Scholar 

  18. Duseja A. Staging of hepatocellular carcinoma. J Clin Exp Hepatol 2014;4(August):S74–S79

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sun H, Song T. Hepatocellular carcinoma: advances in diagnostic imaging. Drug Discov Ther 2015;9(5):310–318

    Article  CAS  PubMed  Google Scholar 

  20. Maida M, Orlando E, Cammà C, Cabibbo G. Staging systems of hepatocellular carcinoma: a review of literature. World J Gastroenterol 2014;20(15):4141–4150

    Article  PubMed  PubMed Central  Google Scholar 

  21. Saraswat VA, Pandey G, Shetty S. Treatment algorithms for managing hepatocellular carcinoma. J Clin Exp Hepatol 2014;4(August):S80–S89

    Article  PubMed  PubMed Central  Google Scholar 

  22. Dufour JF, et al. Clinical practice guidelines EASL—EORTC clinical practice guidelines: management of hepatocellular carcinoma European Organisation for Research and Treatment of Cancer. J Hepatol 2012;56(4):908–943

    Article  Google Scholar 

  23. Kim YS, Lim HK, Rhim H, Lee MW. Ablation of hepatocellular carcinoma. Best Pract Res Clin Gastroenterol 2014;28(5):897–908

    Article  PubMed  Google Scholar 

  24. Livraghi T. Radiofrequency ablation of hepatocellular carcinoma. Surg Oncol Clin N Am 2011;20(2):281–299

    Article  PubMed  Google Scholar 

  25. Kasugai H, Osaki Y, Oka H, Kudo M, Seki T. Severe complications of radiofrequency ablation therapy for hepatocellular carcinoma: an analysis of 3,891 ablations in 2,614 patients. Oncology 2007;72(SUPPL 1):72–75

    Article  PubMed  Google Scholar 

  26. Mulier S, et al. Complications of radiofrequency coagulation of liver tumours. Br J Surg 2002;89(10):1206–1222

    Article  CAS  PubMed  Google Scholar 

  27. Nishikawa H, Kimura T, Kita R, Osaki Y. Radiofrequency ablation for hepatocellular carcinoma. Int J Hyperth 2013;29(6):558–568

    Article  Google Scholar 

  28. Shiina S, et al. Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. Am J Gastroenterol 2012;107(4):569–577

    Article  CAS  PubMed  Google Scholar 

  29. Chen MS, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg 2006;243(3):321–328

    Article  PubMed  PubMed Central  Google Scholar 

  30. Feng K, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma. J Hepatol 2012;57(4):794–802

    Article  PubMed  Google Scholar 

  31. Huang J, et al. A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria. Ann Surg 2010;252(6):903–912

    Article  PubMed  Google Scholar 

  32. Zhou Y, et al. Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma. BMC Gastroenterol 2010;10:1–7

    Article  Google Scholar 

  33. Li L, Zhang J, Liu X, Li X, Jiao B, Kang T. Clinical outcomes of radiofrequency ablation and surgical resection for small hepatocellular carcinoma: a meta-analysis. J Gastroenterol Hepatol 2012;27(1):51–58

    Article  PubMed  Google Scholar 

  34. Earl TM, Chapman WC. Hepatocellular carcinoma: resection versus transplantation. Semin Liver Dis 2013;33(3):282–292

    Article  PubMed  Google Scholar 

  35. Fan ST. Hepatocellular carcinoma—resection or transplant? Nat Rev Gastroenterol Hepatol 2012;9(12):732–737

    Article  PubMed  Google Scholar 

  36. Fonseca AL, Cha CH. Hepatocellular carcinoma : a comprehensive overview of surgical therapy. J Surg Oncol 2014;110:712–719

    Article  PubMed  Google Scholar 

  37. Vitale A, et al. Personalized treatment of patients with very early hepatocellular carcinoma. J Hepatol 2017;66(2):412–423

    Article  PubMed  Google Scholar 

  38. Llovet JM, Fuster J, Bruix J. Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 1999;30(6):1434–1440

    Article  CAS  PubMed  Google Scholar 

  39. Sapisochin G, et al. Single HCC in cirrhotic patients: liver resection or liver transplantation? Long-term outcome according to an intention-to-treat basis. Ann Surg Oncol 2013;20(4):1194–1202

    Article  PubMed  Google Scholar 

  40. Roayaie S. Resection of hepatocellular cancer ≤ 2 CM: results from two western centers. Hepatology 2013;57(4):1426–1435

    Article  PubMed  Google Scholar 

  41. Fahrner R. Liver transplantation for hepatocellular carcinoma—factors influencing outcome and disease-free survival. World J Gastroenterol 2015;21(42):12071

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Mazzaferro V, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996;334(11):693–699

    Article  CAS  PubMed  Google Scholar 

  43. Yao FY, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology 2001;33(6):1394–1403

    Article  CAS  PubMed  Google Scholar 

  44. Mazzaferro V, et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009;10(1):35–43

    Article  PubMed  Google Scholar 

  45. Duffy JP, et al. Liver transplantation criteria for hepatocellular carcinoma should be expanded: a 22-year experience with 467 patients at UCLA. Ann Surg 2007;246(3):502–509

    Article  PubMed  PubMed Central  Google Scholar 

  46. Livraghi T, Mäkisalo H, Line PD. Treatment options in hepatocellular carcinoma today. Scand J Surg 2011;100(1):22–29

    Article  CAS  PubMed  Google Scholar 

  47. Guy J, Kelley RK, Roberts J, Kerlan R, Yao F, Terrault N. Multidisciplinary management of hepatocellular carcinoma. Clin Gastroenterol Hepatol 2012;10(4):354–362

    Article  PubMed  Google Scholar 

  48. Facciuto ME, et al. Surgical dilemma: liver resection or liver transplantation for hepatocellular carcinoma and cirrhosis. Intention-to-treat analysis in patients within and outwith Milan criteria. Hpb 2009;11(5):398–404

    Article  PubMed  PubMed Central  Google Scholar 

  49. Tsochatzis EA, Fatourou E, O’Beirne J, Meyer T, Burroughs AK. Transarterial chemoembolization and bland embolization for hepatocellular carcinoma. World J Gastroenterol 2014;20(12):3069–3077

    Article  PubMed  PubMed Central  Google Scholar 

  50. Facciorusso A, Licinio R, Muscatiello N, Di Leo A, Barone M. Transarterial chemoembolization: evidences from the literature and applications in hepatocellular carcinoma patients. World J Hepatol 2015;7(16):2009–2019

    Article  PubMed  PubMed Central  Google Scholar 

  51. Habib A, Desai K, Hickey R, Thornburg B, Lewandowski R, Salem R. Locoregional therapy of hepatocellular carcinoma. Clin Liver Dis 2015;19(2):401–420

    Article  PubMed  Google Scholar 

  52. Lencioni R. Chemoembolization for hepatocellular carcinoma. Semin Oncol 2012;39(4):503–509

    Article  CAS  PubMed  Google Scholar 

  53. Gao ZH, Bai DS, Jiang GQ, Jin SJ. Review of preoperative transarterial chemoembolization for resectable hepatocellular carcinoma. World J Hepatol 2015;7(1):40–43

    Article  PubMed  PubMed Central  Google Scholar 

  54. Han K, Kim JH. Transarterial chemoembolization in hepatocellular carcinoma treatment: barcelona clinic liver cancer staging system. World J Gastroenterol 2015;21(36):10327–10335

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Jazieh KA, Arabi M, Khankan AA. Transarterial therapy: an evolving treatment modality of hepatocellular carcinoma. Saudi J Gastroenterol 2014;20(6):333–341

    Article  PubMed  PubMed Central  Google Scholar 

  56. Lencioni R, Crocetti L. Local-regional treatment of hepatocellular carcinoma. Radiology 2012;262(1):43–58

    Article  PubMed  Google Scholar 

  57. Lencioni R, Petruzzi P, Crocetti L. Chemoembolization of hepatocellular carcinoma. Semin Interv Radiol 2013;30(1):3–11

    Article  Google Scholar 

  58. Willatt JM, Francis IR, Novelli PM, Vellody R, Pandya A, Krishnamurthy VN. Interventional therapies for hepatocellular carcinoma. Cancer Imaging 2012;12(1):79–88

    Article  PubMed  PubMed Central  Google Scholar 

  59. Boyvat F. Interventional radiologic treatment of hepatocellular carcinoma. Exp Clin Transplant 2017;15:25–30

    PubMed  Google Scholar 

  60. Sangro B, Iñarrairaegui M, Bilbao JI. Radioembolization for hepatocellular carcinoma. J Hepatol 2012;56(2):464–473

    Article  PubMed  Google Scholar 

  61. Sangro B, Salem R, Kennedy A, Coldwell D, Wasan H. Radioembolization for hepatocellular carcinoma: a review of the evidence and treatment recommendations. Am J Clin Oncol 2011;34(4):422–431

    Article  PubMed  Google Scholar 

  62. Sacco R, et al. Transarterial radioembolization for hepatocellular carcinoma: a review. J Hepatocell Carcinoma 2016;3:25–29

    Article  PubMed  PubMed Central  Google Scholar 

  63. Golfieri R, Pettinato C, Cappelli A. Transarterial radioembolization using yttrium-90 microspheres in the treatment of hepatocellular carcinoma: a review on clinical utility and developments. J Hepatocell Carcinoma 2014;1:163–182

    Article  PubMed  PubMed Central  Google Scholar 

  64. Salem R, Lewandowski RJ. Chemoembolization adn radioembolization for hepatocellular carcinoma. Clin Gastroenterol Hepatol 2013;11(6):1–16

    Article  Google Scholar 

  65. Salem R, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology 2011;140(2):497–507

    Article  PubMed  Google Scholar 

  66. Bujold A, Dawson LA. Radiothérapie stéréotaxique et radiothérapie interne sélective du carcinome hépatocellulaire. Cancer Radiother 2011;15(1):54–63

    Article  CAS  PubMed  Google Scholar 

  67. Sangro B, et al. Radioembolization using 90Y-resin microspheres for patients with advanced hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 2006;66(3):792–800

    Article  CAS  PubMed  Google Scholar 

  68. Feng M, Ben-Josef E. Radiation therapy for hepatocellular carcinoma. Semin Radiat Oncol 2011;21(4):271–277

    Article  PubMed  Google Scholar 

  69. Meng M, et al. Stereotactic body radiation therapy: a novel treatment modality for inoperable hepatocellular carcinoma. Drug Discov Ther 2015;9(5):372–379

    Article  PubMed  Google Scholar 

  70. Kondo Y, Kimura O, Shimosegawa T. Radiation therapy has been shown to be adaptable for various stages of hepatocellular carcinoma. World J Gastroenterol 2015;21(1):94–101

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Sanuki N, Takeda A, Kunieda E. Role of stereotactic body radiation therapy for hepatocellular carcinoma. World J Gastroenterol 2014;20(12):3100–3111

    Article  PubMed  PubMed Central  Google Scholar 

  72. Yao FY, et al. Excellent outcome following down-staging of hepatocellular carcinoma prior to liver transplantation: an intention-to-treat analysis. Hepatology 2008;48(3):819–827

    Article  PubMed  Google Scholar 

  73. Toso C, Mentha G, Kneteman NM, Majno P. The place of downstaging for hepatocellular carcinoma. J Hepatol 2010;52(6):930–936

    Article  PubMed  Google Scholar 

  74. Majno PE, et al. Influence of preoperative transarterial lipiodol chemoembolization on resection and transplantation for hepatocellular carcinoma in patients with cirrhosis. Ann Surg 1997;226(6):688–703

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Lewandowski RJ, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant 2009;9(8):1920–1928

    Article  CAS  PubMed  Google Scholar 

  76. Pompili M, Francica G, Ponziani FR, Iezzi R, Avolio AW. Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation. World J Gastroenterol 2013;19(43):7515–7530

    Article  PubMed  PubMed Central  Google Scholar 

  77. Parikh N, Waljee A, Singal A. Downstaging hepatocellular carcinoma: a systematic review and pooled analysis Neehar. Liver Transplant 2007;21:1142–1152

    Article  Google Scholar 

  78. Belghiti J, et al. Resection prior to liver transplantation for hepatocellular carcinoma. Ann Surg 2003;238(6):885–893

    Article  PubMed  PubMed Central  Google Scholar 

  79. Cheng A-L, et al. Sunitinib versus sorafenib in advanced hepatocellular cancer: results of a randomized phase III trial. J Clin Oncol 2013;31(32):4067–4075

    Article  CAS  PubMed  Google Scholar 

  80. Ge S, Huang D. Systemic therapies for hepatocellular carcinoma. Drug Discov Ther 2015;9(5):352–362

    Article  CAS  PubMed  Google Scholar 

  81. Llovet JM, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008;359(4):378–390

    Article  CAS  PubMed  Google Scholar 

  82. Cheng AL, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol 2009;10(1):25–34

    Article  CAS  PubMed  Google Scholar 

  83. Johnson PJ, et al. Brivanib versus sorafenib as first-line therapy in patients with unresectable, advanced hepatocellular carcinoma: results from the randomized phase III BRISK-FL study. J Clin Oncol 2013;31(28):3517–3524

    Article  CAS  PubMed  Google Scholar 

  84. Llovet JM, et al. Brivanib in patients with advanced hepatocellular carcinoma who were intolerant to sorafenib or for whom sorafenib failed: results from the randomized phase III BRISK-PS study. J Clin Oncol 2013;31(28):3509–3516

    Article  CAS  PubMed  Google Scholar 

  85. Cainap C, et al. Linifanib versus sorafenib in patients with advanced hepatocellular carcinoma: results of a randomized phase III trial. J Clin Oncol 2015;33(2):172–179

    Article  CAS  PubMed  Google Scholar 

  86. Zhu AX, et al. SEARCH: a phase III, randomized, double-blind, placebo-controlled trial of sorafenib plus erlotinib in patients with advanced hepatocellular carcinoma. J Clin Oncol 2015;33(6):559–566

    Article  CAS  PubMed  Google Scholar 

  87. Abou-Alfa GK, et al. A phase II study of cixutumumab (IMC-A12, NSC742460) in advanced hepatocellular carcinoma. J Hepatol 2014;60(2):319–324

    Article  CAS  PubMed  Google Scholar 

  88. US Food and Drug Administration. FDA approves lenvatinib for unresectable hepatocellular carcinoma. Silver Spring: US Department of Health and Human Services; 2018

    Book  Google Scholar 

  89. Kudo M, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet 2018;391(10126):1163–1173

    Article  CAS  PubMed  Google Scholar 

  90. Approved drugs - FDA grants accelerated approval to nivolumab for HCC previously treated with sorafenib. Edited by Center for Drug Evaluation and Research, US Food and Drug Administration Home Page, Center for Drug Evaluation and Research. 2017. https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm577166.htm

  91. Approved Drugs - Regorafenib. Edited by Center for Drug Evaluation and Research, US Food and Drug Administration Home Page, Center for Drug Evaluation and Research. 2017. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm555548.htm

  92. Bruix J, et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2017;389(10064):56–66

    Article  CAS  PubMed  Google Scholar 

  93. El-Khoueiry AB, et al. Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. Lancet 2017;389(10088):2492–2502

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Abou-Alfa GK, et al. Cabozantinib in patients with advanced and progressing hepatocellular carcinoma. N Engl J Med 2018;379(1):54–63

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Zhu AX, et al. Ramucirumab versus placebo as second-line treatment in patients with advanced hepatocellular carcinoma following first-line therapy with sorafenib (REACH): a randomised, double-blind, multicentre, phase 3 trial. Lancet Oncol 2015;16(7):859–870

    Article  CAS  PubMed  Google Scholar 

  96. Patt YZ, et al. Oral capecitabine for the treatment of hepatocellular carcinoma, cholangiocarcinoma, and gallbladder carcinoma. Cancer 2004;101(3):578–586

    Article  CAS  PubMed  Google Scholar 

  97. Zaanan A, et al. Gemcitabine plus oxaliplatin in advanced hepatocellular carcinoma: a large multicenter AGEO study. J Hepatol 2013;58(1):81–88

    Article  CAS  PubMed  Google Scholar 

  98. Qin S, et al. Randomized, multicenter, open-label study of oxaliplatin plus fluorouracil/leucovorin versus doxorubicin as palliative chemotherapy in patients with advanced hepatocellular carcinoma from Asia. J Clin Oncol 2013;31(28):3501–3508

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Internal Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA

    Thomas Couri

  2. Division of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA

    Anjana Pillai

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TC has no conflicts of interest to report. AP is on the speaker’s bureau for Eisai and BTG and serves on advisory board for Wako Diagnostics..

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Couri, T., Pillai, A. Goals and targets for personalized therapy for HCC. Hepatol Int 13, 125–137 (2019). https://doi.org/10.1007/s12072-018-9919-1

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