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Treatment strategies for advanced hepatocellular carcinoma: Sorafenib vs hepatic arterial infusion chemotherapy
- Source :
- World Journal of Hepatology. 10:571-584
- Publication Year :
- 2018
- Publisher :
- Baishideng Publishing Group Inc., 2018.
-
Abstract
- Sorafenib is used worldwide as a first-line standard systemic agent for advanced hepatocellular carcinoma (HCC) on the basis of the results of two large-scale Phase III trials. Conversely, hepatic arterial infusion chemotherapy (HAIC) is one of the most recommended treatments in Japan. Although there have been no randomized controlled trials comparing sorafenib with HAIC, several retrospective analyses have shown no significant differences in survival between the two therapies. Outcomes are favorable for HCC patients exhibiting macroscopic vascular invasion when treated with HAIC rather than sorafenib, whereas in HCC patients exhibiting extrahepatic spread or resistance to transcatheter arterial chemoembolization, good outcomes are achieved by treatment with sorafenib rather than HAIC. Additionally, sorafenib is generally used to treat patients with Child-Pugh A, while HAIC is indicated for those with either Child-Pugh A or B. Based on these findings, we reviewed treatment strategies for advanced HCC. We propose that sorafenib might be used as a first-line treatment for advanced HCC patients without macroscopic vascular invasion or Child-Pugh A, while HAIC is recommended for those with macroscopic vascular invasion or Child-Pugh A or B. Additional research is required to determine the best second-line treatment for HAIC non-responders with Child-Pugh B through future clinical trials.
- Subjects :
- Oncology
Sorafenib
medicine.medical_specialty
Hepatology
business.industry
medicine.disease
digestive system diseases
Additional research
law.invention
Clinical trial
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Internal medicine
Hepatic arterial infusion chemotherapy
medicine
Treatment strategy
030211 gastroenterology & hepatology
Transcatheter arterial chemoembolization
business
neoplasms
medicine.drug
Subjects
Details
- ISSN :
- 19485182
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- World Journal of Hepatology
- Accession number :
- edsair.doi...........6459fd7ec7e49bb1af7e5918a25f8e24