TY - JOUR
T1 - Current and future treatments for hepatocellular carcinoma
AU - Schlachterman, Alexander
AU - Craft, Willie W.
AU - Hilgenfeldt, Eric
AU - Mitra, Avir
AU - Cabrera, Roniel
N1 - Publisher Copyright:
© The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2015/7/28
Y1 - 2015/7/28
N2 - Hepatocellular carcinoma (HCC) represents a unique challenge for physicians and patients. There is no definitively curative treatment. Rather, many treatment and management modalities exist with differing advantages and disadvantages. Both current guidelines and individual patient concerns must be taken into account in order to properly manage HCC. In addition, quality of life issues are particularly complex in patients with HCC and these concerns must also be factored into treatment strategies. Thus, considering all the options and their various pros and cons can quickly become complex for both clinicians and patients. In this review, we systematically discuss the current treatment modalities available for HCC, detailing relevant clinical data, risks and rewards and overall outcomes for each approach. Surgical options discussed include resection, transplantation and ablation. We also discuss the radiation modalities: conformal radiotherapy, yttrium 90 microspheres and proton and heavy ion radiotherapy. The biologic agent Sorafenib is discussed as a promising new approach, and recent clinical trials are reviewed. We then detail currently described molecular pathways implicated in the initiation and progression of HCC, and we explore the potential of each pathway as an avenue for drug exploitation. We hope this comprehensive and forward-looking review enables both clinicians and patients to understand various options and thereby make more informed decisions regarding this disease.
AB - Hepatocellular carcinoma (HCC) represents a unique challenge for physicians and patients. There is no definitively curative treatment. Rather, many treatment and management modalities exist with differing advantages and disadvantages. Both current guidelines and individual patient concerns must be taken into account in order to properly manage HCC. In addition, quality of life issues are particularly complex in patients with HCC and these concerns must also be factored into treatment strategies. Thus, considering all the options and their various pros and cons can quickly become complex for both clinicians and patients. In this review, we systematically discuss the current treatment modalities available for HCC, detailing relevant clinical data, risks and rewards and overall outcomes for each approach. Surgical options discussed include resection, transplantation and ablation. We also discuss the radiation modalities: conformal radiotherapy, yttrium 90 microspheres and proton and heavy ion radiotherapy. The biologic agent Sorafenib is discussed as a promising new approach, and recent clinical trials are reviewed. We then detail currently described molecular pathways implicated in the initiation and progression of HCC, and we explore the potential of each pathway as an avenue for drug exploitation. We hope this comprehensive and forward-looking review enables both clinicians and patients to understand various options and thereby make more informed decisions regarding this disease.
KW - Adult
KW - Adult
KW - Hepatic neoplasm
KW - Hepatocellular cancer
KW - Hepatocellular carcinoma
KW - Hepatoma
KW - Liver cancer
KW - Liver cell carcinoma
KW - Liver cell carcinoma
KW - Liver neoplasm
UR - http://www.scopus.com/inward/record.url?scp=84937942493&partnerID=8YFLogxK
U2 - 10.3748/wjg.v21.i28.8478
DO - 10.3748/wjg.v21.i28.8478
M3 - Article
C2 - 26229392
AN - SCOPUS:84937942493
SN - 1007-9327
VL - 21
SP - 8478
EP - 8491
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
IS - 28
ER -