Topic Highlight
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 28, 2014; 20(12): 3087-3099
Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3087
Systemic therapy of hepatocellular carcinoma: Current status and future perspectives
Domenico Germano, Bruno Daniele
Domenico Germano, Bruno Daniele, Oncology Unit, A.O. “G. Rummo”, 82100 Benevento, Italy
Author contributions: Germano D wrote the manuscript; Daniele B contributed to the final revision.
Supported by The consulting and lecture fees from Bayer, Daiichi Sankyo and Novartis to Daniele B
Correspondence to: Domenico Germano, MD, Oncology Unit, A.O. “G. Rummo”, Via dell’Angelo, 1, 82100 Benevento, Italy. domgerm@libero.it
Telephone: +39-82-457709 Fax: +39-82-457709
Received: September 30, 2013
Revised: November 10, 2013
Accepted: January 6, 2014
Published online: March 28, 2014
Processing time: 187 Days and 12.3 Hours
Abstract

The management of hepatocellular carcinoma (HCC) has substantially changed in the past few decades, the introduction of novel therapies (such as sorafenib) have improved patient survival. Nevertheless, HCC remains the third most common cause of cancer-related deaths worldwide. Decision-making largely relies on evidence-based criteria, as showed in the US and European clinical practice guidelines, which endorse five therapeutic recommendations:resection; transplantation; radiofrequency ablation; chemoembolization; and sorafenib. Many molecularly targeted agents that inhibit angiogenesis, epidermal growth factor receptor, and mammalian target of rapamycin are at different stages of clinical development in advanced HCC. Future research should continue to unravel the mechanism of hepatocarcinogenesis and to identify key relevant molecular targets for therapeutic intervention. Identification and validation of potential surrogate and predictive biomarkers hold promise to individualize patient’s treatment to maximize clinical benefit and minimize the toxicity and cost of targeted agents.

Keywords: Hepatocellular Carcinoma; Molecular agents; Targheted therapy; Sorafenib

Core tip: Many molecularly targeted agents that inhibit angiogenesis, epidermal growth factor receptor, and mammalian target of rapamycin are at different stages of clinical development in advanced hepatocellular carcinoma. Future research should continue to unravel the mechanism of hepatocarcinogenesis and to identify key relevant molecular targets for therapeutic intervention.