关键词: Anti-angiogenic therapy CR, complete response Combinational therapy HCC, hepatocellular carcinoma Hepatocellular carcinoma ICI, immune checkpoint inhibitor Molecular targeted therapy ORR, objective response rate OS, overall survival PD-1, program death-1 PD-L1, program death-1 ligand PFS, progression-free survival PR, partial response RECIST, Response Evaluation Criteria in Solid Tumors Systemic therapy TACE, transcatheter chemoembolization TKI, tyrosine kinase inhibitor

来  源:   DOI:10.1016/j.gendis.2020.03.010   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
Liver cancer, mostly hepatocellular carcinoma (HCC), is the second leading cause of cancer mortality globally. Most patients were diagnosed at an advanced stage, and systemic therapy is the standard of care. All the approved systemic therapies for HCC are molecular targeted therapies with anti-angiogenic effects targeting the vascular endothelial growth factor signaling pathway. Sorafenib and lenvatinib are the first-line treatment, and regorafenib, ramucirumab, and cabozantinib are second-line treatment options. Although anti-PD-1 antibodies, including nivolumab and pembrolizumab, demonstrated promising anti-tumor effects as monotherapy for advanced HCC in phase II clinical trials, both failed in phase III studies. Anti-angiogenic treatment remains the backbone of systemic therapy for HCC. In this review, we summarized the approved anti-angiogenic medicines and discussed the potential strategies to improve the efficacy of anti-angiogenic therapy, including combination therapy with other treatments, and discussed the approaches to overcome the drawbacks of anti-angiogenic therapies.
摘要:
肝癌,主要是肝细胞癌(HCC),是全球癌症死亡的第二大原因。大多数患者被诊断为晚期,全身治疗是护理的标准。所有已获批准的HCC全身治疗都是具有靶向血管内皮生长因子信号通路的抗血管生成作用的分子靶向治疗。索拉非尼和lenvatinib是一线治疗,还有Regorafenib,雷莫珠单抗,卡博替尼是二线治疗选择。虽然抗PD-1抗体,包括nivolumab和pembrolizumab,在II期临床试验中作为晚期HCC的单一疗法证明了有希望的抗肿瘤作用,在III期研究中均失败.抗血管生成治疗仍然是HCC全身治疗的支柱。在这次审查中,我们总结了已批准的抗血管生成药物,并讨论了提高抗血管生成疗法疗效的潜在策略,包括与其他治疗的联合治疗,并讨论了克服抗血管生成疗法缺点的方法。
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