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Current Oncology
Volume 27
Issue s3
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..

Curr. Oncol., Volume 27, Issue s3 (November 2020) – 6 articles

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428 KiB  
Review
Management of Hepatocellular Carcinoma after Progression on First-Line Systemic Treatment: Defining the Optimal Sequencing Strategy in Second Line and Beyond
by C. P. Amaro and V. C. Tam
Curr. Oncol. 2020, 27(s3), 173-180; https://doi.org/10.3747/co.27.7103 - 01 Nov 2020
Cited by 5 | Viewed by 1561
Abstract
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. It has a high mortality rate, especially when localized treatments fail. For about a decade, the only systemic treatment shown to improve survival was sorafenib. Recently, lenvatinib was found to [...] Read more.
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. It has a high mortality rate, especially when localized treatments fail. For about a decade, the only systemic treatment shown to improve survival was sorafenib. Recently, lenvatinib was found to be noninferior to sorafenib for overall survival, and combination atezolizumab–bevacizumab improved survival compared with sorafenib. Similarly, in the post-sorafenib setting, a number of recent positive clinical trials have been reported, and they indicate that regorafenib, cabozantinib, and ramucirumab are effective and safe in the second-line setting. With so many new options available, including immunotherapy, it is challenging to define the best sequence of systemic treatment for patients with hcc. In the present review, we introduce the current data for second-line systemic treatment and beyond in HCC. A treatment algorithm is also suggested, based on the best available evidence and expert opinion. Full article
311 KiB  
Review
Non-Immunotherapy Options for the First-Line Management of Hepatocellular Carcinoma: Exploring the Evolving Role of Sorafenib and Lenvatinib in Advanced Disease
by S. Perera, D. Kelly and G. M. O’Kane
Curr. Oncol. 2020, 27(s3), 165-172; https://doi.org/10.3747/co.27.7159 - 01 Nov 2020
Cited by 10 | Viewed by 1719
Abstract
The results of the SHARP trial established sorafenib, a tyrosine kinase inhibitor (TKI), as the sole first-line treatment option in advanced hepatocellular carcinoma (HCC) for more than a decade. In 2020, there has been a surge in new therapies for HCC, including immunotherapeutic [...] Read more.
The results of the SHARP trial established sorafenib, a tyrosine kinase inhibitor (TKI), as the sole first-line treatment option in advanced hepatocellular carcinoma (HCC) for more than a decade. In 2020, there has been a surge in new therapies for HCC, including immunotherapeutic strategies and the approval of a number of novel TKIs. In addition to sorafenib, lenvatinib and combination atezolizumab–bevacizumab now represent standard first-line treatment options. As those systemic therapy options begin to be better utilized, assurance of adequate liver function and optimal timing are required to improve patient outcomes. Furthermore, sequencing of the agents will have to be carefully tailored, given the increasing armamentarium of choices. Here, we discuss the role of lenvatinib and sorafenib in the first-line management of HCC. Full article
628 KiB  
Review
Role of Immunotherapy in the Management of Hepatocellular Carcinoma: Current Standards and Future Directions
by A. Weinmann and P. R. Galle
Curr. Oncol. 2020, 27(s3), 152-164; https://doi.org/10.3747/co.27.7315 - 01 Nov 2020
Cited by 14 | Viewed by 2120
Abstract
The multikinase inhibitor sorafenib was the only approved systemic therapy in advanced hepatocellular carcinoma (HCC) for about a decade. In recent years, the number of approved agents has increased significantly as a result of a number of positive phase iii clinical trials. Lenvatinib [...] Read more.
The multikinase inhibitor sorafenib was the only approved systemic therapy in advanced hepatocellular carcinoma (HCC) for about a decade. In recent years, the number of approved agents has increased significantly as a result of a number of positive phase iii clinical trials. Lenvatinib as a first-line treatment, and regorafenib, cabozantinib, and ramucirumab in the second-line setting are now approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency. In phase II studies, immunotherapy with nivolumab and monotherapy using pembrolizumab yielded impressive results for overall survival in therapy-naïve and pretreated patients, leading to the accelerated approval by the FDA of nivolumab and pembrolizumab for second-line treatment. However, phase III trials of nivolumab in the first line and pembrolizumab in the second line as single agents failed to reach statistical significance, although clinical benefit for a subset of patients with long durations of response could be demonstrated. Despite that setback, immunotherapy for HCC is a promising therapeutic approach, and the combination of immunotherapy with other treatment modalities such as monoclonal antibodies, tyrosine kinase inhibitors, or local therapies has the potential to increase the overall response rate and survival. Recently, the results of a phase III trial of combination atezolizumab–bevacizumab compared with sorafenib showed a highly significant survival benefit and median overall survival that was not reached in the immunotherapy arm, making the combination the preferred standard of care in first-line therapy. Despite the impressive results and generally good toxicity profile of immunotherapy, patients who respond to therapy constitute only a subset of the overall population, and response rates are still limited. This review focuses on the currently reported results and ongoing clinical trials of checkpoint inhibitor–based immunotherapy in HCC. Full article
432 KiB  
Review
Current Locoregional Therapies and Treatment Strategies in Hepatocellular Carcinoma
by L. Cardarelli-Leite, A. Hadjivassiliou, D. Klass, J. Chung, S. G. F. Ho, H. J. Lim, P. T. W. Kim, A. Mujoomdar and D. M. Liu
Curr. Oncol. 2020, 27(s3), 144-151; https://doi.org/10.3747/co.27.7171 - 01 Nov 2020
Cited by 12 | Viewed by 1330
Abstract
Locoregional therapies (LRTs) play an important role in the treatment of hepatocellular carcinoma (HCC), with the aim of increasing overall survival while preserving liver function. Various forms of LRT are available, and choosing the best one depends on technical aspects, liver morphology, tumour [...] Read more.
Locoregional therapies (LRTs) play an important role in the treatment of hepatocellular carcinoma (HCC), with the aim of increasing overall survival while preserving liver function. Various forms of LRT are available, and choosing the best one depends on technical aspects, liver morphology, tumour biology, and the patient’s symptoms. The purpose of the present review article is to provide an overview of the current evidence relating to the use of percutaneous ablation, transarterial chemoembolization, and transarterial radioembolization for the curative or palliative treatment of HCC. Special situations are also reviewed, including the combined use of systemic therapy and LRT, indications and techniques for bridging to transplant and downstaging, and the use of LRT to treat patients with HCC and macrovascular invasion. Full article
226 KiB  
Review
Hepatocellular Carcinoma: Epidemiology, Screening, and Assessment of Hepatic Reserve
by S. Z. Frager and J. M. Schwartz
Curr. Oncol. 2020, 27(s3), 138-143; https://doi.org/10.3747/co.27.7181 - 01 Nov 2020
Cited by 31 | Viewed by 3104
Abstract
Hepatocellular carcinoma is a leading cause of cancer-related mortality worldwide. This review summarizes the epidemiology and causes of the disease, and the roles of screening and surveillance for early tumour detection. It also highlights the important role of assessment of hepatic reserve in [...] Read more.
Hepatocellular carcinoma is a leading cause of cancer-related mortality worldwide. This review summarizes the epidemiology and causes of the disease, and the roles of screening and surveillance for early tumour detection. It also highlights the important role of assessment of hepatic reserve in consideration of appropriate staging and treatment. Full article
100 KiB  
Editorial
The Evolving Treatment Landscape of Hepatocellular Carcinoma: More Choices, More Responsibility
by Sharlene Gill
Curr. Oncol. 2020, 27(s3), 136-137; https://doi.org/10.3747/co.27.6143 - 01 Nov 2020
Cited by 1 | Viewed by 536
Abstract
Hepatocellular carcinoma (hcc) is the 4th most common cause of cancer-related deaths worldwide1 [...] Full article
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