Place of sorafenib in the treatment of hepatocellular carcinoma

Abstract

The advancement in the systemic treatment of hepatocellular carcinoma (HCC) has improved prospects for the overall survival rate in patients with the advanced form of the tumour. In this overview, the newtargeted therapy is set in the context of both traditional and the latest therapeutical methods, which include - besides livertransplant, partial hepatectomy, radiofrequency ablation and alcoholization - also radiotherapy, immunotherapy, chemotherapy and biological therapy. Local therapy is usually preferred to systemic therapy. Patients for whom locoregional therapy is not suitable due to advanced disease can benefit from systemic therapy. The targeted therapy with sorafenib, a multiple tyrosine kinase inhibitor, which was proven in the SHARP study to produce a statistically significant improvement in the overall survival rate of patients with advanced HCC, has become a new standard in systemic therapy of advanced HCC. Sorafenib demonstrated high efficacy in monotherapy compared to the placebo and isthe first and so far only drug which has significantly improved the overall survival rate in patients with HCC. Other biological drugs include bevacizumab, sunitinib and erlotinib. To conclude, current recommendations on HCC treatment are presented.