The onset of hepatocellular carcinoma (HCC) is related to the development of non-neoplastic liver disease,
such as viral infections and cirrhosis. Even though patients with chronic liver diseases undergo clinical surveillance for
early diagnosis of HCC, this cancer is often diagnosed in advanced stage. In this case locoregional treatment is not possible
and systemic therapies are the best way to control it. Until now sorafenib, a Raf and multi-kinase inhibitor has been
the best, choice to treat HCC systemically. It showed a survival benefit in multicenter phase III trials. However the proper
patient setting to treat is not well defined, since the results in Child-Pugh B patients are conflicting. To date various new
target drugs are under developed and other biological treatments normally indicated in other malignancies are under investigation
also for HCC. These strategies aim to target the different biological pathways implicated in HCC development
and progression. The target drugs studied in HCC include anti-VEGF and anti-EGFR monoclonal antibodies, tyrosine
kinase inhibitors and mTOR inhibitors. The most important challenge is represented by the best integration of these drugs
with standard treatments to achieve improvement in overall survival and quality of life.
Keywords: Cirrhosis, hepatocellular carcinoma, liver disease, targeted therapies.
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