Published online Aug 28, 2016. doi: 10.3748/wjg.v22.i32.7252
Peer-review started: April 9, 2016
First decision: May 12, 2016
Revised: June 7, 2016
Accepted: July 21, 2016
Article in press: July 21, 2016
Published online: August 28, 2016
Hepatocellular carcinoma (HCC) is one of the deadliest cancers in the world and is associated with a high risk of recurrence. The development of a wide range of new therapies is therefore essential. In this study, from the perspective of supportive therapy for the prevention of HCC recurrence and preservation of liver function in HCC patients, we surveyed a variety of different therapeutic agents. We show that branched chain amino acids (BCAA) supplementation and late evening snack with BCAA, strategies that address issues of protein-energy malnutrition, are important for liver cirrhotic patients with HCC. For chemoprevention of HCC recurrence, we show that viral control after radical treatment is important. We also reviewed the therapeutic potential of antiviral drugs, sorafenib, peretinoin, iron chelators. Sorafenib is a kinase inhibitor and a standard therapy in the treatment of advanced HCC. Peretinoin is a vitamin A-like molecule that targets the retinoid nuclear receptor to induce apoptosis and inhibit tumor growth in HCC cells. Iron chelators, such as deferoxamine and deferasirox, act to prevent cancer cell growth. These chelators may have potential as combination therapies in conjunction with peretinoin. Finally, we review the potential inhibitory effect of bone marrow cells on hepatocarcinogenesis.
Core tip: Hepatocellular carcinoma (HCC) is one of the deadliest cancers in the world and is associated with a high risk of recurrence. Because liver function worsens upon repeated treatment for HCC recurrence, therapies that preserve liver function are essential. Here, we survey a variety of different therapeutic agents and then review the current status and prospects for prevention of HCC recurrence, particularly from the perspective of supportive therapy to preserve liver function. The agents included branched-chain amino acids (BCAA) supplementation, late evening snacking with BCAA, antiviral drugs, sorafenib, peretinoin, iron chelators, and bone marrow cells.