한빛사논문
- 조회106
University of Calgary, 동남권원자력의학원
Sang Youn Hwang 1,2, Sangjune L. Lee 3, Hongqun Liu 1, Samuel S. Lee 1
1Liver Unit, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
2Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan, South Korea.
3Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada.
Corresponding author : Samuel S. Lee
Abstract
Background: Immune checkpoint inhibitor (ICI)-based therapy such as atezolizumab plus bevacizumab or durvalumab plus tremelimumab became mainstream first-line systemic treatment in advanced hepatocellular carcinoma (HCC) patients since remarkably superior efficacy of ICI-based therapy compared to tyrosine kinase inhibitors (TKIs) was reported in two recent randomized controlled trials (RCTs) (IMbrave150, HIMALAYA). However, the optimal second-line therapy after treatment failure of first-line ICI-based therapy remains unknown as no RCT has examined this issue.
Summary: Therefore, at present, most clinicians are empirically treating patients with TKIs or retrial of ICI or locoregional treatment (LRT) modality such as transarterial therapy, radiofrequency ablation, and radiation therapy in this clinical setting without solid evidence. In this review, we will discuss current optimal strategies for second-line treatment after the failure of first-line ICI-based therapy by reviewing published studies and ongoing prospective trials.
Key messages: Clinicians should consider carefully whether to treat the patients with TKI, other ICI-based therapy, or LRT in this situation by considering several factors including liver function reserve, performance status, adverse events of previous therapy, and presence of lesion that can consider LRT such as oligoprogression and vascular invasion. In the meantime, we await the results of ongoing prospective trials to elucidate the best management options.
논문정보
- Review Paper
- 2024년 06월 (BRIC 등록일 2024-07-09)
- 국내+국외 연구진
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