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Hepatocellular carcinoma, systemic therapy, sorafenib, nivolumab
For decade, systemic treatments in advanced stage hepatocellular carcinoma (HCC), except sorafenib, were not very effective even though there were tremendous effort in developing new therapy. Until last 2 years, Nivolumab, the new immune check point inhibitor, has shown promising activity in phase I/II study and have been approved by USFDA to treat patients in first and second line due to their benefits on overall survival and the adequate safety profile. Not only nivolumab, but also lenvatinib; multikinase inhibitor, is approved in advanced HCC due to a positive impact on the overall survival. Still sorafenib is the drug that have been used to treat unresectable HCC for over 10 years with best benefits on overall survival and the adequate safety profile in selected patients. Therefore, this article was to reveal all the data about systemic therapies that were used in advanced stage HCC include indication, dosage, patient and drug’s profile and safety. The strategy to precisely select treatment for advanced or unresectable HCC is now more challenging than ever before because there were many promising drugs available in the market. Thus, as a clinician, we are responsible to gather all the important information from patients to choose the best treatment option not only to prolong survival but to achieve complete response in these metastasis liver cancers.
Figure 1 ยาที่ได้รับการรับรองจากองค์การอาหารและยาของประเทศสหรัฐอเมริกาในการรักษามะเร็งตับระยะลุกลาม
- มะเร็งตับระยะ B หมายถึง มะเร็งตับระยะ Intermediated แบ่งตาม Barcelona Clinic Liver Cancer
- มะเร็งตับระยะ C หมายถึง มะเร็งตับระยะ Advanced แบ่งตาม Barcelona Clinic Liver Cancer