Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Tuesday, 10 / 24 / 2017

Articles

Chemotherapy for Hepatocellular Carcinoma: Current Evidence and Future Perspectives

REVIEW ARTICLE

Chemotherapy for Hepatocellular Carcinoma: Current Evidence and Future Perspectives

Emanuele Rinninella*1,2, Lucia Cerrito1, Irene Spinelli1, Marco Cintoni2, Maria Cristina Mele2, Maurizio Pompili1 and Antonio Gasbarrini1

1Internal Medicine and Gastroenterology Unit, Gastroenterology Area, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy
2Clinical Nutrition Unit, Gastroenterology Area, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy

*Correspondence to: Emanuele Rinninella, Gastroenterology Area, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome 00168, Italy. Tel: +39-06-3015-6265, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(3):235-248 DOI: 10.14218/JCTH.2017.00002
Received: January 9, 2017 Accepted: April 29, 2017 Published online: June 8, 2017

Abstract

Hepatocarcinogenesis is a multistep process, heralded by abnormalities in cell differentiation and proliferation and sustained by an aberrant neoangiogenesis. Understanding the underlying molecular pathogenesis leading to hepatocellular carcinoma is a prerequisite to develop new drugs that will hamper or block the steps of these pathways. As hepatocellular carcinoma has higher arterial vascularization than normal liver, this could be a good target for novel molecular therapies. Introduction of the antiangiogenic drug sorafenib into clinical practice since 2008 has led to new perspectives in the management of this tumor. The importance of this drug lies not only in the modest gain of patients’ survival, but in having opened a roadmap towards the development of new molecules and targets. Unfortunately, after the introduction of sorafenib, during the last years, a wide number of clinical trials on antiangiogenic therapies failed in achieving significant results. However, many of these trials are still ongoing and promise to improve overall survival and progression-free survival. A recent clinical trial has proven regorafenib effective in patients showing tumor progression under sorafenib, thus opening new interesting therapeutic perspectives. Many other expectations have been borne from the discovery of the immune checkpoint blockade, already known in other solid malignancies. Furthermore, a potential role in hepatocellular carcinoma therapy may derive from the use of branched-chain amino acids and of nutritional support. This review analyses the biomolecular pathways of hepatocellular carcinoma and the ongoing studies, the actual evidence and the future perspectives concerning drug therapy in this open field.

Keywords

Hepatocellular carcinoma, Molecular target therapies, Immunotherapy, Branched-chain amino acids

 

Journal of Clinical and Translational Hepatology 2017 vol. 5, 235-248  Html ] [ PDF Full-text ]

 

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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