Open AccessSystemic Therapy for Hepatocellular Carcinoma: Current Updates and Outlook
Author(s) -
Yinjie Fan,
Hang Xue,
Haixue Zheng
Publication year - 2022
Publication title -
journal of hepatocellular carcinoma
Language(s) - English
Resource type - Journals
ISSN - 2253-5969
DOI - 10.2147/jhc.s358082
Subject(s) - ramucirumab , medicine , regorafenib , nivolumab , sorafenib , lenvatinib , hepatocellular carcinoma , oncology , combination therapy , bevacizumab , pembrolizumab , systemic therapy , ipilimumab , atezolizumab , targeted therapy , cabozantinib , cancer , immunotherapy , colorectal cancer , chemotherapy , breast cancer
Hepatocellular carcinoma (HCC) has emerged the culprit of cancer-related mortality worldwide with its dismal prognosis climbing. In recent years, ground-breaking progress has been made in systemic therapy for HCC. Targeted therapy based on specific signaling molecules, including sorafenib, lenvatinib, regorafenib, cabozantinib, and ramucirumab, has been widely used for advanced HCC (aHCC). Immunotherapies such as pembrolizumab and nivolumab greatly improve the survival of aHCC patients. More recently, synergistic combination therapy has boosted first-line (atezolizumab in combination with bevacizumab) and second-line (ipilimumab in combination with nivolumab) therapeutic modalities for aHCC. This review aims to summarize recent updates of systemic therapy relying on the biological mechanisms of HCC, particularly highlighting the approved agents for aHCC. Adjuvant and neoadjuvant therapy, as well as a combination with locoregional therapies (LRTs), are also discussed. Additionally, we describe the promising effect of traditional Chinese medicine (TCM) as systemic therapy on HCC. In this setting, the challenges and future directions of systemic therapy for HCC are also explored.