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Abstract Details
Systemic Therapy in Metastatic Hepatocellular Carcinoma
1Division of Hematology and Oncology, Loyola University Medical Center, Maywood, IL, USA.
2Division of Hematology and Oncology, Loyola University Medical Center, Maywood, IL, USA. adhanarajan@lumc.edu.
Abstract
Purpose of review: Multiple new tyrosine kinase inhibitors, immunotherapies and anti-angiogenic therapies are now available for the treatment of advanced hepatocellular carcinoma (HCC). In this article, we reviewed the evidence supporting these new therapies.
Recent findings: The combination of atezolizumab and bevacizumab has become a new standard of care for initial systemic therapy in eligible patients, replacing sorafenib in the first line for many patients. Lenvatinib, a multikinase inhibitor, is also a new first line treatment option for patients who are not eligible for immunotherapy. Several additional options for second line treatment were also reviewed in detail in this paper. New systemic therapies for advanced HCC have prolonged overall survival. However, these new therapies are primarily approved for patients with Child-Pugh A classification with few options for patients with Child-Pugh B disease. Further work is needed to expand options for patients with more advanced liver disease and to optimize the sequencing of these new therapies.
Keywords: Advanced hepatocellular carcinoma; Hepatocellular carcinoma; Immunotherapy in hepatocellular carcinoma; Metastatic hepatocellular carcinoma; Targeted therapies in hepatocellular carcinoma.