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Review
. 2020 May 28;7(2):HEP20.
doi: 10.2217/hep-2020-0004.

Systemic treatment of hepatocellular carcinoma: from sorafenib to combination therapies

Christoph Roderburg  1 , Burcin Özdirik  1 , Alexander Wree  1 , Münevver Demir  1 , Frank Tacke  1
Affiliations
Review

Systemic treatment of hepatocellular carcinoma: from sorafenib to combination therapies

Christoph Roderburg et al. Hepat Oncol. .

Abstract

For almost a decade, systemic therapy of advanced hepatocellular carcinoma (HCC) was limited to the tyrosine kinase inhibitor (TKI) sorafenib. Different agents including checkpoint inhibitors, TKIs and anti-VEGFR antibodies demonstrated efficacy in treatment. For the first time, the combination of atezolizumab and bevacizumab, a first-line treatment that is superior to the current standard was identified, potentially changing the way we treat HCC. In this review, we summarize current data on systemic treatment of patients with advanced HCC, focusing on combination therapies comprising immune checkpoint inhibitors, TKIs and locoregional therapies. We elucidate findings from recent trials and discuss such challenges as the lack of predictive biomarkers for identification of subgroups that will benefit from novel treatment strategies.

Keywords: VEGFR2; combination therapies; hepatocellular carcinoma; immunotherapy; tyrosine kinase inhibitor.

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Conflict of interest statement

Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1.
Figure 1.. Proposed treatment algorithm of medical treatment in hepatocellular carcinoma patients.
See this image and copyright information in PMC

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