Small molecule-based targeted therapy in liver cancer

Liver cancer is one of the most prevalent malignant tumors worldwide. According to the staging criteria of Barcelona Clinic Liver Cancer, clinical guidelines provide tutorials to clinical management of liver cancer at their individual stages. However, most patients diagnosed with liver cancer are at advanced stage, thereby, many researchers conduct investigations on targeted therapy, aiming to improve the overall survival of these patients. To date, small molecule-based targeted therapies are highly recommended (fist-line: Sorafenib and Lenvatinib; second-line: Regorafenib and Cabozantinib) by current clinical guidelines of American Society of Clinical Oncology, European Society for Medical Oncology, and National Comprehensive Cancer Network. Herein, we summarize the small molecule-based targeted therapies in liver cancer, including the approved and preclinical therapies as well as the therapies under clinical trials, and introduce their history of discovery, clinical trials, indications, and molecular mechanisms. For drug resistance, the revealed mechanisms of action and the combination therapies are also discussed. In fact, the known small molecule-based therapies still have limited clinical benefits to liver cancer patients. Therefore, we analyze the current status and give our ideas for the urgent issues and future directions in this field, suggesting the clues for novel techniques in liver cancer treatment.