Title:Advances in the Pharmacologic Treatment of Hepatocellular Carcinoma
VOLUME: 10 ISSUE: 4
Author(s):Neil H. Bhayani, Yixing Jiang, Osama Hamed, Eric T. Kimchi, Kevin F. Staveley-O’Carroll and Niraj J. Gusani
Affiliation:Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033-0850, USA.
Keywords:Adjuvant therapy, bevacizumab, chemotherapy, doxorubicin, hepatocellular carcinoma, sorafenib, toxicity.
Abstract:Medical therapy for hepatocellular carcinoma (HCC) is an area of active investigation
because fewer than 25% of patients are candidates for curative resection or transplantation. Single
agent doxorubicin, the former standard of care, generated a 10% tumor response but resulted in
substantial toxicity. The resulting recommendation of the NCCN has been to administer cytotoxic
chemotherapy only under clinical protocol. More recently, newer drugs with more specific targets have
forced re-consideration of palliative chemotherapy in clinical practice. Bevacizumab is a promising
therapy but data is limited to Phase 2 trials without impressive results. Sorafenib is the prototype
multi-kinase inhibitor, which has demonstrated some but limited survival benefit in advanced HCC. This has subsequently
become the standard of care. Epidermal growth factor receptor, the target of rapamycin (mTOR) pathway, transforming
growth factor-β, and cyclin-dependent kinases have been recent targets of ongoing study for potential therapeutics.
Overall, current therapeutics have been so promising that adjuvant therapy after curative treatment in under investigation
to reduce recurrence.
