Treatment options for unresectable hepatocellular carcinoma
DOI:
https://doi.org/10.29303/jku.v10i4.604Keywords:
Hepatocellular Carcinoma, TreatmentAbstract
Hepatocellular carcinoma (HCC) is a primary liver cancer that occurs due to the abnormal growth of hepatocytes. HCC is one of the cancers with the highest prevalence and incidence in the world. The main risk factors for HCC in Indonesia are chronic infection with hepatitis B virus, hepatitis C virus, and liver cirrhosis. The selection of the appropriate treatment modality for each patient is based on several patient-specific characteristics, such as tumor size, location, portal vein thrombosis, and liver function. Treatment options for unresectable hepatocellular carcinoma include intra-arterial therapy, multikinase inhibitors, and immunotherapy. Determining the stage is an important part of managing HCC because it can determine the treatment. One of the staging systems is the Barcelona Clinic Liver Cancer (BCLC) which categorizes HCC into 5 stages. Clinical severity criteria with BCLC stage are often used because they have good validity in predicting the prognosis of HCC patients.
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2. RP M, Hardian H. Distribusi Geografis Dan Tingkat Keparahan Pasien Karsinoma Hepatoseleluler Etiologi Virus Hepatitis B Di Rs.Dr Kariadi. Diponegoro Med J (Jurnal Kedokt Diponegoro). 2016;5(4):1291–302.
3. Eggert T, Greten TF. Current Standard and Future Perspectives in Non-Surgical Therapy for Hepatocellular Carcinoma. Physiol Behav. 2017;176(1):139–48.
4. Kinoshita A, Onoda H, Fushiya N, Koike K, Nishino H, Tajiri H. Staging systems for hepatocellular carcinoma: Current status and future perspectives. World J Hepatol. 2015;7(3):406–24.
5. Makary MS, Khandpur U, Cloyd JM, Mumtaz K, Dowell JD. Locoregional therapy approaches for hepatocellular carcinoma: Recent advances and management strategies. Cancers (Basel). 2020;12(7):1–18.
6. Tsochatzis EA, Fatourou E, O’Beirne J, Meyer T, Burroughs AK. Transarterial chemoembolization and bland embolization for hepatocellular carcinoma. World J Gastroenterol. 2014;20(12):3069–77.
7. Lee EW, Khan S. Recent advances in transarterial embolotherapies in the treatment of hepatocellular carcinoma. Clin Mol Hepatol. 2017;23(4):265–72.
8. Kluger MD, Halazun KJ, Barroso RT, Fox AN, Olsen SK, Madoff DC, et al. Bland Embolization Versus Chemoembolization of Hepatocellular Carcinoma Before Transplantation. Liver Transplant. 2014;13(5):767–8.
9. Gbolahan OB, Schacht MA, Beckley EW, LaRoche TP, O’Neil BH, Pyko M. Locoregional and systemic therapy for hepatocellular carcinoma. J Gastrointest Oncol. 2017;8(2):215–28.
10. Melchiorre F, Patella F, Pescatori L, Pesapane F, Fumarola E, Biondetti P, et al. DEB-TACE: a standard review. Futur Oncol. 2018 Jul;14(28):2969–84.
11. Inchingolo R, Posa A, Mariappan M, Spiliopoulos S. Locoregional treatments for hepatocellular carcinoma: Current evidence and future directions. World J Gastroenterol. 2019;25(32):4614–28.
12. Lencioni R, Llovet JM, Han G, Tak WY, Yang J, Guglielmi A, et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate stage HCC: The SPACE trial. J Hepatol. 2016 May;64(5):1090–8.
13. Kennedy A, Brown DB, Feilchenfeldt J, Marshall J, Wasan H, Fakih M, et al. Safety of selective internal radiation therapy (SIRT) with yttrium-90 microspheres combined with systemic anticancer agents: Expert consensus. J Gastrointest Oncol. 2017;8(6):1079–99.
14. Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358–80.
15. Ng KKC, Chok KSH, Chan ACY, Cheung TT, Wong TCL, Fung JYY, et al. Randomized clinical trial of hepatic resection versus radiofrequency ablation for early-stage hepatocellular carcinoma. Br J Surg. 2017;104(13):1775–84.
16. Facciorusso A, Di Maso M, Muscatiello N. Drug-eluting beads versus conventional chemoembolization for the treatment of unresectable hepatocellular carcinoma: A meta-analysis. Dig Liver Dis. 2016 Jun;48(6):571–7.
17. Wang C, Wang H, Yang W, Hu K, Xie H, Hu KQ, et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma. Hepatology. 2015;61(5):1579–90.
18. Chen S, Cao Q, Wen W, Wang H. Targeted therapy for hepatocellular carcinoma: Challenges and opportunities. Cancer Lett [Internet]. 2019;460(June):1–9. Available from: https://doi.org/10.1016/j.canlet.2019.114428
19. Qin S, Finn RS, Kudo M, Meyer T, Vogel A, Ducreux M, et al. RATIONALE 301 study: Tislelizumab versus sorafenib as first-line treatment for unresectable hepatocellular carcinoma. Futur Oncol. 2019;15(16):1811–22.
20. Zhang L, Ding J, Li HY, Wang ZH, Wu J. Immunotherapy for advanced hepatocellular carcinoma, where are we? Biochim Biophys Acta - Rev Cancer [Internet]. 2020;1874(2):188441. Available from: https://doi.org/10.1016/j.bbcan.2020.188441
21. Dipasquale A, Marinello A, Santoro A. A Comparison of Lenvatinib versus Sorafenib in the First-Line Treatment of Unresectable Hepatocellular Carcinoma: Selection Criteria to Guide Physician’s Choice in a New Therapeutic Scenario. J Hepatocell Carcinoma. 2021;Volume 8:241–51.
22. Tomonari T, Sato Y, Tanaka H, Tanaka T, Fujino Y, Mitsui Y, et al. Potential use of lenvatinib for patients with unresectable hepatocellular carcinoma including after treatment with sorafenib: Real-world evidence and in vitro assessment via protein phosphorylation array. Oncotarget. 2020;11(26):2531–42.
23. Ettrich TJ, Seufferlein T. Regorafenib. 2018;45–56. Available from: https://pubmed.ncbi.nlm.nih.gov/30069758/
24. Alnaggar M, Lin M, Mesmar A, Liang S, Qaid A, Xu K, et al. Allogenic Natural Killer Cell Immunotherapy Combined with Irreversible Electroporation for Stage IV Hepatocellular Carcinoma: Survival Outcome. Cell Physiol Biochem. 2018;48(5):1882–93.
25. Doherty DG. Immunity, tolerance and autoimmunity in the liver: A comprehensive review. J Autoimmun. 2016 Jan;66:60–75.
26. Wang H, Liu A, Bo W, Feng X, Hu Y, Tian L, et al. Adjuvant immunotherapy with autologous cytokine-induced killer cells for hepatocellular carcinoma patients after curative resection, a systematic review and meta-analysis. Dig Liver Dis. 2016 Nov;48(11):1275–82.
27. Brunner SM, Rubner C, Kesselring R, Martin M, Griesshammer E, Ruemmele P, et al. Tumor-infiltrating, interleukin-33-producing effector-memory CD8+ T cells in resected hepatocellular carcinoma prolong patient survival. Hepatology. 2015;61(6):1957–67.
28. Luo P, Yin P, Hua R, Tan Y, Li Z, Qiu G, et al. A Large-scale, multicenter serum metabolite biomarker identification study for the early detection of hepatocellular carcinoma. Hepatology. 2018;67(2):662–75.
29. Katz SC, Burga RA, McCormack E, Wang LJ, Mooring W, Point G, et al. Phase I Hepatic Immunotherapy for Metastases study of intraarterial chimeric antigen receptor modified T cell therapy for CEA+ liver metastases. Physiol Behav. 2016;176(1):139–48.
30. El-Khoueiry AB, Sangro B, Yau T, Crocenzi TS, Kudo M, Hsu C, et al. Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. Lancet. 2017;389(10088):2492–502.
31. Zhu AX, Finn RS, Edeline J, Cattan S, Ogasawara S, Palmer D, et al. Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): a non-randomised, open-label phase 2 trial. Lancet Oncol. 2018 Jul;19(7):940–52.
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Published
2022-01-22
How to Cite
Budyono, C., Ainun Fatiha DP, Baiq Aliza K.I, & I Gede Prabananda A. (2022). Treatment options for unresectable hepatocellular carcinoma. Jurnal Kedokteran, 10(4), 666–672. https://doi.org/10.29303/jku.v10i4.604
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Literature Review
