Opportunities and challenges of multidisciplinary conversion therapy in advanced hepatocellular carcinoma DOI Open Access

Ju-Hang Chu,

Luyao Huang,

Yaru Wang

et al.

Current Cancer Reports, Journal Year: 2024, Volume and Issue: 6, P. 225 - 229

Published: Sept. 11, 2024

Surgical resection is still the most important radical treatment for primary hepatocellular carcinoma (HCC), but at present, rate of newly diagnosed patients with HCC only 30%. The recurrence suitable surgical within 5 years after surgery as high 40%~70%. Low initial and postoperative are reasons restricting overall effects in China. Under this background, effectively improving reducing have become key topics to improve HCC. Some initially unresectable may access through conversion therapy. Conversion therapy, which mainly involves combination local, systemic, multiple strategies, offers hope advanced But there some who do not benefit from So, how success one challenges that clinicians need solve.

Language: Английский

Lenvatinib and immune-checkpoint inhibitors in hepatocellular carcinoma: mechanistic insights, clinical efficacy, and future perspectives DOI Creative Commons
Yuhang Chen,

Suoyi Dai,

Chien‐shan Cheng

et al.

Journal of Hematology & Oncology, Journal Year: 2024, Volume and Issue: 17(1)

Published: Dec. 21, 2024

Lenvatinib is a multi-target tyrosine kinase inhibitor widely used in the treatment of hepatocellular carcinoma (HCC). Its primary mechanism action involves inhibiting signal pathways such as vascular endothelial growth factor receptors (VEGFR) and fibroblast (FGFR), thereby reducing tumor cell proliferation angiogenesis affecting tumor's immune microenvironment. In liver cancer, although lenvatinib monotherapy has shown good clinical effect, problem drug resistance becoming more serious. This may be caused by variety factors, including genetic mutations, signaling pathway remodeling, changes order to overcome resistance, combination other therapeutic strategies gradually become research hotspot, it worth noting that checkpoint inhibitors (ICIs) application prospect. not only enhances anti-tumor response but also helps improve efficacy. However, therapy faces challenges regarding safety tolerability. Therefore, studying mechanisms identifying relevant biomarkers particularly important, aids early diagnosis personalized treatment. article reviews treating efficacy its with inhibitors, causes exploration biomarkers, novel for lenvatinib. We hope provide insights into use scientific settings, offering new cancer.

Language: Английский

Citations

9
The Treatment of Hepatocellular Carcinoma with Major Vascular Invasion DOI Open Access
Tomoko Tadokoro, Joji Tani, Asahiro Morishita

et al.

Cancers, Journal Year: 2024, Volume and Issue: 16(14), P. 2534 - 2534

Published: July 14, 2024

Vascular invasion of hepatocellular carcinoma involves tumor plugs in the main trunk portal vein, bile ducts, and veins, it indicates poor prognosis. It is often associated with hypertension, which requires evaluation management. Treatment includes hepatic resection, systemic pharmacotherapy, arterial infusion chemotherapy, radiation therapy. Recurrence rates post-hepatic resection are high, drug therapy has limited therapeutic potential patients a reserve. Single therapies generally inadequate, necessitating combining multiple adjuvant pharmacotherapy before after hepatectomy. This narrative review will provide an overview treatment vascular invasion.

Language: Английский

Citations

7
Predicting the early therapeutic response to hepatic artery infusion chemotherapy in patients with unresectable HCC using a contrast-enhanced computed tomography-based habitat radiomics model: a multi-center retrospective study DOI Creative Commons
Mingsong Wu,

Zenglong Que,

Shujie Lai

et al.

Cellular Oncology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 4, 2025

Predicting the therapeutic response before initiation of hepatic artery infusion chemotherapy (HAIC) with fluorouracil, leucovorin, and oxaliplatin (FOLFOX) remains challenging for patients unresectable hepatocellular carcinoma (HCC). Herein, we investigated potential a contrast-enhanced CT-based habitat radiomics model as novel approach predicting early to HAIC-FOLFOX in HCC. A total 148 HCC who received combined targeted therapy or immunotherapy at three tertiary care medical centers were enrolled retrospectively. Tumor features extracted from subregion based on CECT different phases using k-means clustering. Logistic regression was used construct model. This CECT-based verified by bootstrapping compared clinical variables. Model performance evaluated area under curve (AUC) calibration curve. Three intratumoral habitats high, moderate, low enhancement identified prediction. Patients greater proportion high-enhancement showed better responses. The AUC 0.857 (95% CI: 0.798–0.916), bootstrap-corrected concordance index 0.842 0.785–0.907), resulting predictive value than variable-based model, which had an 0.757 0.679–0.834). is effective, visualized, noninvasive tool treatment could guide management decision-making.

Language: Английский

Citations

1
Hepatic arterial infusion chemotherapy enhances the efficacy of lenvatinib plus PD-1 inhibitors in hepatocellular carcinoma patients with tumor thrombosis in the inferior vena cava and/or right atrium DOI
Yidan Lou, Xiaoling Zhang, Pengfei Sun

et al.

Academic Radiology, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 1, 2024

Language: Английский

Citations

3
Hepatic arterial infusion chemotherapy enhances the efficacy of lenvatinib and PD-1 inhibitors for advanced hepatocellular carcinoma: a meta-analysis and trial sequential analysis DOI

Jiahui Yu,

Yong Li, Junsheng Yu

et al.

European Journal of Surgical Oncology, Journal Year: 2025, Volume and Issue: 51(3), P. 109573 - 109573

Published: Jan. 6, 2025

Language: Английский

Citations

0
Lenvatinib and tislelizumab versus atezolizumab and bevacizumab in combination with TAE-HAIC for unresectable hepatocellular carcinoma with high tumor burden: a multicenter retrospective cohort study DOI Creative Commons

Hongjie Cai,

Song Chen, Shuang‐Yan Tang

et al.

Cancer Immunology Immunotherapy, Journal Year: 2025, Volume and Issue: 74(3)

Published: Feb. 1, 2025

Language: Английский

Citations

0
Enhanced antitumor activity of combined hepatic arterial infusion chemotherapy with Lenvatinib and PD-1 inhibitors in unresectable hepatocellular carcinoma: a meta-analysis DOI Creative Commons
Lingling Zhao, Cheng Xu, Jiewen Deng

et al.

Frontiers in Oncology, Journal Year: 2025, Volume and Issue: 15

Published: Feb. 12, 2025

Background Hepatic arterial infusion chemotherapy (HAIC) is increasingly recognized as a primary treatment option for patients with unresectable hepatocellular carcinoma (uHCC), providing focused localized tumors. The combination of lenvatinib, multikinase inhibitor, PD-1 inhibitors has demonstrated significant survival benefits in HCC. This meta-analysis aims to assess whether the integration HAIC lenvatinib and (referred HAIC-L-P group) leads better effectiveness security compared alone (L-P uHCC. Methods An exhaustive search literature was conducted, including PubMed, Cochrane Library, Embase, ClinicalTrials.gov, Web Science, from start each database until September 2024, ensure thorough up-to-date compilation relevant studies. Extract data on outcome measures such overall (OS), progression-free (PFS), objective response rate (ORR), disease control (DCR), adverse events (AEs). Subsequently, meta-analyses were performed using RevMan 5.4 quantitatively evaluate aggregated effect regimen versus L-P alone. Results In our systematic eight retrospective cohort studies, markedly enhanced OS, an HR 0.54 (95% CI: 0.45-0.64; p < 0.00001), 1-year 2-year OS rates. Superior PFS also observed group, 0.64 0.55-0.75; 0.0001), higher Response rates ORR risk ratio 2.15 1.84-2.50; 0.00001) DCR 1.28 1.20-1.43; 0.0001). AEs classified grade 3 or above elevated notable ratios vomiting, AST, ALT, thrombocytopenia, neutropenia, hyperbilirubinemia. No life-threatening reported. Conclusion correlated tumor responses prolonged survival, alongside manageable effects, indicating its potential viable therapeutic strategy individuals afflicted Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42024594109.

Language: Английский

Citations

0
Adverse events associated with hepatic arterial infusion chemotherapy and its combination therapies in hepatocellular carcinoma: a systematic review DOI Creative Commons
Ying Wu, Zhimin Zeng,

Shuanggang Chen

et al.

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: March 3, 2025

Background Hepatic arterial infusion chemotherapy (HAIC) has emerged as a promising treatment for unresectable hepatocellular carcinoma (HCC). However, the safety profiles of HAIC and its various combination therapies remain to be systematically evaluated. Methods We searched PubMed, Embase, Cochrane Library, Web Science databases from inception November 2024. Studies reporting adverse events (AEs) monotherapy or in HCC were included. The severity frequency AEs analyzed according different protocols. Results A total 58 studies (11 prospective, 47 retrospective) demonstrated relatively mild toxicity, primarily affecting hepatobiliary (transaminase elevation 53.2%, hypoalbuminemia 57.2%) hematological systems (anemia 43.0%, thrombocytopenia 35.2%). with targeted therapy showed increased events, including characteristic reactions like hand-foot syndrome (48.0%) hypertension (49.9%). combined targeted, immunotherapy exhibited highest reaction rates (neutropenia 82.9%, transaminase 97.1%), while anti-angiogenic favorable profile. Prospective consistently reported higher incidence than retrospective studies, suggesting potential underreporting clinical practice. Conclusions Different HAIC-based regimens exhibit distinct requiring individualized management approaches. propose comprehensive framework patient selection, monitoring strategies, AE management. These recommendations aim optimize outcomes minimizing impacts on quality life.

Language: Английский

Citations

0
Efficacy and safety of HAIC-FOLFOX plus tyrosine kinase inhibitors and immune checkpoint inhibitors as first-line treatment for unresectable advanced hepatocellular carcinoma: A systematic review and meta-analysis DOI Creative Commons

Peng Jiang,

Chao Chen,

Jing Tian

et al.

Academic Radiology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 1, 2024

Advanced hepatocellular carcinoma (HCC) has been treated with targeted therapy, immunotherapy, or a combination of both, however, the overall clinical efficacy is still unsatisfactory. Hepatic arterial infusion chemotherapy (HAIC), as localized treatment modality, demonstrated favorable therapeutic in patients advanced HCC accompanied by portal vein tumor thrombus and extensive intrahepatic metastasis. In recent years, HAIC immune therapy gradually gained acceptance East Asian countries. However, further investigation necessary to assess safety this triple therapy.

Language: Английский

Citations

0
Opportunities and challenges of multidisciplinary conversion therapy in advanced hepatocellular carcinoma DOI Open Access

Ju-Hang Chu,

Luyao Huang,

Yaru Wang

et al.

Current Cancer Reports, Journal Year: 2024, Volume and Issue: 6, P. 225 - 229

Published: Sept. 11, 2024

Surgical resection is still the most important radical treatment for primary hepatocellular carcinoma (HCC), but at present, rate of newly diagnosed patients with HCC only 30%. The recurrence suitable surgical within 5 years after surgery as high 40%~70%. Low initial and postoperative are reasons restricting overall effects in China. Under this background, effectively improving reducing have become key topics to improve HCC. Some initially unresectable may access through conversion therapy. Conversion therapy, which mainly involves combination local, systemic, multiple strategies, offers hope advanced But there some who do not benefit from So, how success one challenges that clinicians need solve.

Language: Английский

Citations

0