Review

. 2022 Jan 4;11(3):192-208.

doi: 10.1159/000521596. eCollection 2022 Jun.

Systemic Therapy for Hepatocellular Carcinoma: Chinese Consensus-Based Interdisciplinary Expert Statements

Yongkun Sun¹, Wen Zhang¹, Xinyu Bi², Zhengqiang Yang³, Yu Tang⁴, Liming Jiang⁵, Feng Bi⁶, Minshan Chen⁷, Shuqun Cheng⁸, Yihebali Chi¹, Yue Han³, Jing Huang¹, Zhen Huang², Yuan Ji⁹, Liqun Jia¹⁰, Zhichao Jiang¹, Jing Jin¹¹, Zhengyu Jin¹², Xiao Li³, Zhiyu Li², Jun Liang¹³, Lianxin Liu¹⁴, Yunpeng Liu¹⁵, Yinying Lu¹⁶, Shichun Lu¹⁷, Qinghua Meng¹⁸, Zuoxing Niu¹⁹, Hongming Pan²⁰, Shukui Qin²¹, Wang Qu¹, Guoliang Shao²², Feng Shen²³, Tianqiang Song²⁴, Yan Song¹, Kaishan Tao²⁵, Aiping Tian²⁶, Jianhua Wang²⁷, Wenling Wang²⁸, Zhe Wang²⁹, Liqun Wu³⁰, Feng Xia³¹, Baocai Xing³², Jianming Xu³³, Huadan Xue¹², Dong Yan³, Lin Yang¹, Jianming Ying³⁴, Jingping Yun³⁵, Zhaochong Zeng³⁶, Xuewen Zhang³⁷, Yanqiao Zhang³⁸, Yefan Zhang², Jianjun Zhao², Jianguo Zhou², Xu Zhu³⁹, Yinghua Zou⁴⁰, Jiahong Dong⁴¹, Jia Fan⁴², Wan Yee Lau⁴³, Yan Sun¹, Jinming Yu⁴⁴, Hong Zhao², Aiping Zhou¹, Jianqiang Cai²

Affiliations

¹ Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Department of Interventional Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴ Department of GCP Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵ Department of Diagnostic Imaging, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁶ Department of Medical Oncology, West China Hospital, Chengdu, China.
⁷ Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
⁸ The Six Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
⁹ Department of Pathology, Zhongshan Hospital Fudan University, Shanghai, China.
¹⁰ Department of Oncology of Integrative Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, China.
¹¹ Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
¹² Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
¹³ Department of Medical Oncology, Peking University International Hospital, Beijing, China.
¹⁴ Department of Hepatic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China.
¹⁵ Department of Medical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China.
¹⁶ Department of Comprehensive Liver Cancer Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
¹⁷ Department of Hepatobiliary Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China.
¹⁸ Department of Clinical Care Medicine of Liver Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
¹⁹ Department of Medical Oncology, Shandong Cancer Hospital and Institute, Jinan, China.
²⁰ Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
²¹ Department of Medical Oncology, PLA Cancer Centre of Nanjing Bayi Hospital, Nanjing, China.
²² Department of Interventional Radiology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China.
²³ Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
²⁴ Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
²⁵ Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
²⁶ Department of Traditional Chinese Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
²⁷ Department of Interventional Radiology, Zhongshan Hospital Fudan University, Shanghai, China.
²⁸ Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guizhou Cancer Hospital, Guiyang, China.
²⁹ Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
³⁰ Department of Hepatic Biliary Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
³¹ Department of Hepatobiliary Surgery, The Southwest Hospital of AMU, Chongqing, China.
³² Department of Hepatobiliary and Pancreatic Surgery Unit I, Beijing Cancer Hospital, Beijing, China.
³³ Department of Gastrointestinal Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
³⁴ Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³⁵ Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China.
³⁶ Department of Radiology, Zhongshan Hospital Fudan University, Shanghai, China.
³⁷ Department of Hepatobiliary and Pancreatic Surgery, Second Hospital of Jilin University, Changchun, China.
³⁸ Department of Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
³⁹ Department of Interventional Radiology, Beijing Cancer Hospital, Beijing, China.
⁴⁰ Department of Interventional Radiology, Peking University First Hospital, Beijing, China.
⁴¹ Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, Beijing, China.
⁴² Department of Liver Surgery, Zhongshan Hospital Fudan University, Shanghai, China.
⁴³ Department of Hepatic Biliary Pancreatic Surgery, The Chinese University of Hong Kong, Hong Kong, China.
⁴⁴ Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Taian, China.

PMID: 35949289
PMCID: PMC9218612
DOI: 10.1159/000521596

Review

Systemic Therapy for Hepatocellular Carcinoma: Chinese Consensus-Based Interdisciplinary Expert Statements

Yongkun Sun et al. Liver Cancer. 2022.

. 2022 Jan 4;11(3):192-208.

doi: 10.1159/000521596. eCollection 2022 Jun.

Authors

Affiliations

¹ Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Department of Interventional Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴ Department of GCP Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵ Department of Diagnostic Imaging, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁶ Department of Medical Oncology, West China Hospital, Chengdu, China.
⁷ Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
⁸ The Six Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
⁹ Department of Pathology, Zhongshan Hospital Fudan University, Shanghai, China.
¹⁰ Department of Oncology of Integrative Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, China.
¹¹ Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
¹² Department of Radiology, Peking Union Medical College Hospital, Beijing, China.
¹³ Department of Medical Oncology, Peking University International Hospital, Beijing, China.
¹⁴ Department of Hepatic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China.
¹⁵ Department of Medical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China.
¹⁶ Department of Comprehensive Liver Cancer Center, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
¹⁷ Department of Hepatobiliary Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China.
¹⁸ Department of Clinical Care Medicine of Liver Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
¹⁹ Department of Medical Oncology, Shandong Cancer Hospital and Institute, Jinan, China.
²⁰ Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
²¹ Department of Medical Oncology, PLA Cancer Centre of Nanjing Bayi Hospital, Nanjing, China.
²² Department of Interventional Radiology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China.
²³ Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
²⁴ Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
²⁵ Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
²⁶ Department of Traditional Chinese Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
²⁷ Department of Interventional Radiology, Zhongshan Hospital Fudan University, Shanghai, China.
²⁸ Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guizhou Cancer Hospital, Guiyang, China.
²⁹ Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
³⁰ Department of Hepatic Biliary Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
³¹ Department of Hepatobiliary Surgery, The Southwest Hospital of AMU, Chongqing, China.
³² Department of Hepatobiliary and Pancreatic Surgery Unit I, Beijing Cancer Hospital, Beijing, China.
³³ Department of Gastrointestinal Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
³⁴ Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³⁵ Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China.
³⁶ Department of Radiology, Zhongshan Hospital Fudan University, Shanghai, China.
³⁷ Department of Hepatobiliary and Pancreatic Surgery, Second Hospital of Jilin University, Changchun, China.
³⁸ Department of Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
³⁹ Department of Interventional Radiology, Beijing Cancer Hospital, Beijing, China.
⁴⁰ Department of Interventional Radiology, Peking University First Hospital, Beijing, China.
⁴¹ Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, Beijing, China.
⁴² Department of Liver Surgery, Zhongshan Hospital Fudan University, Shanghai, China.
⁴³ Department of Hepatic Biliary Pancreatic Surgery, The Chinese University of Hong Kong, Hong Kong, China.
⁴⁴ Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Taian, China.

PMID: 35949289
PMCID: PMC9218612
DOI: 10.1159/000521596

Abstract

Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer and causes many cancer-related deaths worldwide; in China, it is the second most prevalent cause of cancer deaths. Most patients are diagnosed clinically with advanced stage disease.

Summary: For more than a decade, sorafenib, a small-molecular-weight tyrosine kinase inhibitor (SMW-TKI) was the only molecular targeted drug available with a survival benefit for the treatment of advanced HCC. With the development of novel TKIs and immune checkpoint inhibitors for advanced HCC, the management of patients has been greatly improved. However, though angiogenic-based targeted therapy remains the backbone for the systemic treatment of HCC, to date, no Chinese guidelines for novel molecular targeted therapies to treat advanced HCC have been established. Our interdisciplinary panel on the treatment of advanced HCC comprising hepatologists, hepatobiliary surgeons, oncologists, radiologists, pathologists, orthopedic surgeons, traditional Chinese medicine physicians, and interventional radiologists has reviewed the literature in order to develop updated treatment regimens.

Key messages: Panel consensus statements for the appropriate use of new molecular -targeted drugs including doses, combination therapies, adverse reaction management as well as efficacy evaluation, and predictions for treatment of advanced HCC with evidence levels based on published data are presented, thereby providing an overview of molecular targeted therapies for healthcare professionals.

Keywords: Chinese interdisciplinary experts; Consensus; Hepatocellular carcinoma; Molecular targeted therapy.

PubMed Disclaimer

Conflict of interest statement

Jia Fan is an editorial board member of Liver Cancer. The remaining authors have no conflicts of interest to declare.

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Systemic Therapy for Hepatocellular Carcinoma: Chinese Consensus-Based Interdisciplinary Expert Statements

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Systemic Therapy for Hepatocellular Carcinoma: Chinese Consensus-Based Interdisciplinary Expert Statements

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