Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety

Hepatocellular carcinoma (HCC) is a severe complication of advanced liver disease with a worldwide incidence of more than 600,000 patients per year. Liver function, clinical performance status, and tumor size are considered in the Barcelona Clinic Liver Cancer (BCLC) system. While curative treatment...

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Main Authors:	Welker, Martin-Walter, Trojan, Joerg
Format:	Online
Language:	English
Published:	Dove Medical Press 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804539/

id	pubmed-3804539
recordtype	oai_dc
spelling	pubmed-38045392013-11-07 Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety Welker, Martin-Walter Trojan, Joerg Review Hepatocellular carcinoma (HCC) is a severe complication of advanced liver disease with a worldwide incidence of more than 600,000 patients per year. Liver function, clinical performance status, and tumor size are considered in the Barcelona Clinic Liver Cancer (BCLC) system. While curative treatment options are available for early stages, most patients present with intermediate- or advanced-stage HCC, burdened with a poor prognosis, substantially influenced by the degree of liver-function impairment. Hypervascularization is a major characteristic of HCC, and antiangiogenic treatments are the basis of treatment in noncurative stages, including interventional and pharmacological treatments. Currently, the tyrosine-kinase inhibitor sorafenib is still the only approved drug for HCC. Further improvements in survival in patients with intermediate- and advanced-stage HCC may be anticipated by both multimodal approaches, such as combination of interventional and systemic treatments, and new systemic treatment options. Until now, the Phase III development of other tyrosine-kinase inhibitors in patients with advanced HCC has failed due to minor efficacy and/or increased toxicity compared to sorafenib. However, promising Phase II data have been reported with MET inhibitors in this hard-to-treat population. This review gives a critical overview of antiangiogenic drugs and strategies in intermediate- and advanced-stage HCC, with a special focus on safety. Dove Medical Press 2013-10-08 /pmc/articles/PMC3804539/ /pubmed/24204170 http://dx.doi.org/10.2147/CMAR.S35029 Text en © 2013 Welker and Trojan. This work is published by Dove Medical Press Ltd, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Ltd, provided the work is properly attributed.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Welker, Martin-Walter Trojan, Joerg
spellingShingle	Welker, Martin-Walter Trojan, Joerg Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety
author_facet	Welker, Martin-Walter Trojan, Joerg
author_sort	Welker, Martin-Walter
title	Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety
title_short	Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety
title_full	Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety
title_fullStr	Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety
title_full_unstemmed	Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety
title_sort	antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety
description	Hepatocellular carcinoma (HCC) is a severe complication of advanced liver disease with a worldwide incidence of more than 600,000 patients per year. Liver function, clinical performance status, and tumor size are considered in the Barcelona Clinic Liver Cancer (BCLC) system. While curative treatment options are available for early stages, most patients present with intermediate- or advanced-stage HCC, burdened with a poor prognosis, substantially influenced by the degree of liver-function impairment. Hypervascularization is a major characteristic of HCC, and antiangiogenic treatments are the basis of treatment in noncurative stages, including interventional and pharmacological treatments. Currently, the tyrosine-kinase inhibitor sorafenib is still the only approved drug for HCC. Further improvements in survival in patients with intermediate- and advanced-stage HCC may be anticipated by both multimodal approaches, such as combination of interventional and systemic treatments, and new systemic treatment options. Until now, the Phase III development of other tyrosine-kinase inhibitors in patients with advanced HCC has failed due to minor efficacy and/or increased toxicity compared to sorafenib. However, promising Phase II data have been reported with MET inhibitors in this hard-to-treat population. This review gives a critical overview of antiangiogenic drugs and strategies in intermediate- and advanced-stage HCC, with a special focus on safety.
publisher	Dove Medical Press
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804539/
_version_	1612019793652613120

Antiangiogenic treatment in hepatocellular carcinoma: the balance of efficacy and safety

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