We conducted a comprehensive review of the current literature of published data and clinical trials (MEDLINE), as well as published congress contributions and active recruiting clinical trials on targeted therapies in hepatocellular carcinoma. Combinations of different agents and medical therapy along with radiological interventions were analyzed for the setting of advanced HCC. Those settings were also analyzed in combination with adjuvant situations after resection or radiological treatments. We summarized the current knowledge for each therapeutic setting and combination that currently is or has been under clinical evaluation. We further discuss the results in the background of current treatment guidelines. In addition, we review the pathophysiological mechanisms and pathways for each of these investigated targets and drugs to further elucidate the molecular background and underlying mechanisms of action. Established and recommended targeted treatment options that already exist for patients are considered for systemic treatment: atezolizumab/bevacizumab, durvalumab/tremelimumab, sorafenib, lenvatinib, cabozantinib, regorafenib, and ramucirumab. Combination treatment for systemic treatment and local ablative treatment or transarterial chemoembolization and adjuvant and neoadjuvant treatment strategies are under clinical investigation.
我们对已发表的肝细胞癌靶向治疗相关文献数据、临床试验（MEDLINE数据库）、已发表的会议论文及正在招募的临床试验进行了全面综述。针对晚期肝细胞癌，我们分析了不同药物联合方案、药物治疗与放射介入治疗相结合的多种模式，并探讨了这些方案在切除术后或放射治疗后的辅助治疗场景中的应用。我们系统总结了当前处于临床评估阶段或已完成临床评估的各类治疗方案及其组合的现有认知，并结合现行治疗指南对研究结果进行了深入探讨。此外，我们回顾了各研究靶点及药物的病理生理机制与作用通路，以进一步阐明其分子背景与潜在作用机理。目前已确立并推荐用于患者全身治疗的靶向治疗方案包括：阿特珠单抗/贝伐珠单抗、度伐利尤单抗/替西木单抗、索拉非尼、仑伐替尼、卡博替尼、瑞戈非尼及雷莫西尤单抗。全身治疗联合局部消融治疗或经动脉化疗栓塞的联合方案，以及辅助与新辅助治疗策略，目前正处于临床研究阶段。
Insights in Molecular Therapies for Hepatocellular Carcinoma
肿瘤(癌症)患者之家