Session Speaker

Molecular Targeted Therapy for Advanced Hepatocellular Carcinoma
Thomas Yau
Hong Kong

Systemic chemotherapy has had a disappointing track record in the management of advanced hepatocellular carcinoma (HCC). Single-agent doxorubicin produces a response rate of 10-15%, but without any survival benefit, and combination chemotherapy has also yielded unimpressive results. With recent advances in the knowledge of hepato-carcinogenesis, there has been encouraging development in the systemic therapy of advanced HCC patients, and particularly in the targeted therapy of advanced HCC. Among the newly identified targets, exciting results have been shown in targeting the anti-angiogenic pathway and the Raf/mitogen-activated protein kinase (MAPK) pathways. Bevacizumab both as a single agent and in combination with other agents has shown initial encouraging activity in treating advanced HCC. More recently, single agent sorafenib, a putative multi-targeted kinase inhibitor, has shown to prolong the overall survival of patients with advanced HCC in the pivotal phase III SHARP and Oriental study. Currently, sorafenib is the only approved targeted therapy for patients with advanced HCC. In addition, however, promising early results have been reported for other molecularly-targeted drugs including erlotinib and sunitinib. Future progress seems likely to depend upon using controlled clinical trials to optimize synergistic combination treatments.