Systemic therapies in hepatocellular carcinoma: A revolution?

Marta Fortuny, Maria Reig, Marco Sanduzzi-Zamparelli

Journal: United European gastroenterology journal 2024;12(2):252-260

PMID: 38267015

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Abstract

The evolution in systemic therapies in hepatocellular carcinoma (HCC) signifies a strategy of high-cost, high-gain innovation that originated with sorafenib, despite its limited impact on tumor response. This strategic approach paved the way for the emergence of a second wave of the short-lived competitive advantage, exemplified by the incorporation of atezolizumab plus bevacizumab and tremelimumab plus durvalumab. In the context of safety concerns within the liver cancer domain, the IMBRAVE150 and HIMALAYA trials boldly incorporated bevacizumab and tremelimumab, respectively, demonstrating the continuation of the high-risk, high-reward innovation paradigm. This review delves into the strengths, weaknesses, opportunities, and threats analysis of systemic therapies in the field of HCC.

Address: Barcelona Clinic Liver Cancer (BCLC) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Liver Oncology Unit, Liver Unit, Hospital Clinic de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain.; Barcelona Clinic Liver Cancer (BCLC) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Liver Oncology Unit, Liver Unit, Hospital Clinic de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Barcelona Clinic Liver Cancer (BCLC) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Liver Oncology Unit, Liver Unit, Hospital Clinic de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.; Barcelona University, Barcelona, Spain.

DOI: 10.1002/ueg2.12510

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MeSH Terms: Humans, Carcinoma, Hepatocellular, Bevacizumab, Liver Neoplasms, Sorafenib