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LIVER CANCER

Locoregional versus systemic therapy — robust positive data remain elusive

Developments in the treatment of advanced-stage hepatocellular carcinoma include novel locoregional interventions aiming to induce tumour necrosis and systemic treatments targeting the biological mechanisms of tumour progression, thus aiming to delay progression. These approaches fiercely battle to provide the best survival, but their lack of success to date suggests that they might be better tested as a complementary approach.

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References

  1. Forner, A., Reig, M. & Bruix, J. Hepatocellular carcinoma. Lancet 391, 1301–1314 (2018).

    Article  PubMed  Google Scholar 

  2. Llovet, J. M. et al. Sorafenib in advanced hepatocellular carcinoma. N. Engl. J. Med. 359, 378–390 (2008).

    Article  PubMed  CAS  Google Scholar 

  3. Kudo, M. et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet 391, 1163–1173 (2018).

    Article  PubMed  CAS  Google Scholar 

  4. Yoon, S. M. et al. Efficacy and safety of transarterial chemoembolization plus external beam radiotherapy versus sorafenib in hepatocellular carcinoma with macroscopic vascular invasion. JAMA Oncol. 4, 661–669 (2018).

    Article  PubMed  Google Scholar 

  5. Galle, P. R. et al. EASL Clinical Practice Guidelines: management of hepatocellular carcinoma. J. Hepatol. 56, 908–943 (2018).

    Google Scholar 

  6. Huang, L. et al. Correlation between overall survival (OS) and time to progression (TTP) and between OS and response rate (RR) by RECIST in advanced hepatocellular carcinoma (HCC). Ann. Oncol. https://doi.org/10.1093/annonc/mdx369.086 (2017).

    Article  PubMed  Google Scholar 

  7. Reig, M. et al. Postprogression survival of patients with advanced hepatocellular carcinoma: rationale for second-line trial design. Hepatology 58, 2023–2031 (2013).

    Article  PubMed  CAS  Google Scholar 

  8. Vilgrain, V. et al. Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol. 18, 1624–1636 (2017).

    Article  PubMed  CAS  Google Scholar 

  9. Chow, P. K. H. et al. SIRveNIB: selective internal radiation therapy versus sorafenib in Asia-Pacific patients with hepatocellular carcinoma. J. Clin. Oncol. https://doi.org/10.1200/JCO.2017.76.0892 (2018).

    Article  PubMed  Google Scholar 

  10. Ricke, Sangro, B. et al. The impact of combining selective internal radiation therapy (SIRT) with sorafenib on overall survival in patients with advanced hepatocellular carcinoma: the Soramic trial palliative cohort. J. Hepatol. 68, S65–S104 (2018).

    Article  Google Scholar 

Download references

Acknowledgements

J.B. gratefully acknowledges grant support from Instituto de Salud Carlos III (PI14/00962), Asociación Española Contra el Cáncer (AECC; PI044031), Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2014 SGR 605), and Worldwide Cancer Research (WCR; formerly known as AICR) 16–0026. CIBER of Hepatic and Digestive Diseases (CIBERehd) is funded by the Instituto de Salud Carlos III.

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Correspondence to Jordi Bruix.

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J.B. had acted as a consultant of Abbvie, Arqule, Bayer, Boehringer Ingelheim, BMS, BTG, Eisai, Gilead, Kowa, Novartis, Onxeo, OSI, Roche, Sirtex, and Terumo and has a research contract with Bayer. M.S.Z. declares no competing interests.

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Sanduzzi-Zamparelli, M., Bruix, J. Locoregional versus systemic therapy — robust positive data remain elusive. Nat Rev Clin Oncol 15, 537–538 (2018). https://doi.org/10.1038/s41571-018-0047-6

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