伦瓦提尼
肝细胞癌
瑞戈非尼
催眠药
无容量
卡波扎尼布
脂肪性肝炎
临床试验
医学
贝伐单抗
癌症
内科学
乙型肝炎病毒
阿替唑单抗
索拉非尼
肿瘤科
脂肪肝
免疫疗法
免疫学
结直肠癌
疾病
病毒
化疗
作者
Josep M. Llovet,Robin Kate Kelley,Augusto Villanueva,Amit G. Singal,Eli Pikarsky,Sasan Roayaie,Riccardo Lencioni,Kazuhiko Koike,Richard Moreau,Richard S. Finn
标识
DOI:10.7326/0003-4819-87-5-642_1
摘要
Liver cancer remains a global health challenge, with an estimated incidence of >1 million cases by 2025. Hepatocellular carcinoma (HCC) is the most common form of liver cancer and accounts for ~90% of cases. Infection by hepatitis B virus and hepatitis C virus are the main risk factors for HCC development, although non-alcoholic steatohepatitis associated with metabolic syndrome or diabetes mellitus is becoming a more frequent risk factor in the West. Moreover, non-alcoholic steatohepatitis-associated HCC has a unique molecular pathogenesis. Approximately 25% of all HCCs present with potentially actionable mutations, which are yet to be translated into the clinical practice. Diagnosis based upon non-invasive criteria is currently challenged by the need for molecular information that requires tissue or liquid biopsies. The current major advancements have impacted the management of patients with advanced HCC. Six systemic therapies have been approved based on phase III trials (atezolizumab plus bevacizumab, sorafenib, lenvatinib, regorafenib, cabozantinib and ramucirumab) and three additional therapies have obtained accelerated FDA approval owing to evidence of efficacy. New trials are exploring combination therapies, including checkpoint inhibitors and tyrosine kinase inhibitors or anti-VEGF therapies, or even combinations of two immunotherapy regimens. The outcomes of these trials are expected to change the landscape of HCC management at all evolutionary stages.
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