Current State of Liver-Directed Therapies and Combinatory Approaches with Systemic Therapy in Hepatocellular Carcinoma (HCC)

Cancers
Pedro ViveirosDevalingam Mahalingam

Abstract

The increasing set of liver-directed therapies (LDT) have become an integral part of hepatocellular carcinoma (HCC) treatment. These range from percutaneous ablative techniques to arterial embolization, and varied radiotherapy strategies. They are now used for local disease control, symptom palliation, and bold curative strategies. The big challenge in the face of these innovative and sometimes overlapping technologies is to identify the best opportunity of use. In real practice, many patients may take benefit from LDT used as a bridge to curative treatment such as resection and liver transplantation. Varying trans-arterial embolization strategies are used, and comparison between established and developing technologies is scarce. Also, radioembolization utilizing yttrium-90 (Y-90) for locally advanced or intermediate-stage HCC needs further evidence of clinical efficacy. There is increasing interest on LDT-led changes in tumor biology that could have implications in systemic therapy efficacy. Foremost, additional to its apoptotic and necrotic properties, LDT could warrant changes in vascular endothelial growth factor (VEGF) expression and release. However, trans-arterial chemoembolization (TACE) used alongside tyrosine-kinase i...Continue Reading

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Sep 4, 2020·Journal of Gastrointestinal Cancer·Ramazan Kutlu, Sinan Karatoprak
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Methods Mentioned

BETA
surgical resection
flow cytometry

Clinical Trials Mentioned

NCT03898921
NCT02921139
NCT03905967
NCT02837029
NCT03812562
NCT03572582
NCT03143270
NCT03099564

Software Mentioned

SIRveNIB

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Apoptosis

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