肝癌靶向治疗的临床研究进展

Advances in clinical studies of targeted treatment for hepatocellular carcinoma

原发性肝癌是我国最常见的恶性肿瘤之一,多数患者就诊时已属晚期,既往传统细胞毒化疗药对晚期肝癌疗效差。近年来,随着分子生物学的深入研究,分子靶向药物的临床应用为肝癌的治疗带来了新突破。索拉非尼是一种口服的多激酶抑制剂,通过阻断RAF信号传导通路及血管内皮生长因子受体(VEGFR)而抑制肿瘤细胞增殖。Ⅲ期临床研究表明索拉非尼能延长患者生存期,是首个被批准用于治疗晚期肝细胞癌的标准药物。舒尼替尼和brivanib等靶向药物的Ⅰ～Ⅱ期临床试验结果也证明了在晚期肝癌中的有效性,Ⅲ期临床研究正在进行中,期望能给患者提供更多更好的治疗选择。

Hepatocellular carcinoma（HCC） is one of most common malignant tumors in China.Most of patients are in advanced stage at the time of first diagnosis.Conventional chemotherapy has shown poor effect for advanced HCC.With recent years＇ profound research of molecular biology,targeted treatment has appeared as a breakthrough in the treatment of advanced HCC.Sorafenib is an oral multiple kinase inhibitor.It inhibits tumor angiogenesis through blocking the RAF signaling pathway and the activity of vascular endothelial growth factor（VEGF）.The phase III clinical trials showed that sorafenib,the first medicine approved to be used in patients with unresectable HCC,is able to increase survival of patients.Moreover,phase I～II trials of targeted medicine such as sunitinib and brivanib has also shown their effectiveness in the treatment of advanced HCC.In the mean time,phase III clinical study is proceeding with the hope to provide the patients with more and better choices.