Sorafenib has been considered the standard of care for patients with advanced unresectable hepatocellular carcinoma(HCC) since 2007 and numerous studieshave investigated the role of markers involved in the angiogenesi...Sorafenib has been considered the standard of care for patients with advanced unresectable hepatocellular carcinoma(HCC) since 2007 and numerous studieshave investigated the role of markers involved in the angiogenesis process at both the expression and genetic level and clinical aspect. What results have ten years of research produced? Several clinical and biological markers are associated with prognosis. The most interesting clinical parameters are adverse events, Barcelona Clinic Liver Cancer stage, and macroscopic vascular invasion, while several single nucleotide polymorphisms and plasma angiopoietin-2 levels represent the most promising biological biomarkers. A recent pooled analysis of two phase III randomized trials showed that the neutrophil-to-lymphocyte ratio, etiology and extra-hepatic spread are predictive factors of response to sorafenib, but did not identify any predictive biological markers. After 10 years of research into sorafenib there are still no validated prognostic or predictive factors of response to the drug in HCC. The aim of the present review was to summarize 10 years of research into sorafenib, looking in particular at the potential of associated clinical and biological markers to predict its efficacy in patients with advanced HCC.展开更多
Since the adoption of Milan criteria more than 20 years ago,selection criteria for liver transplantation(LT)in patients suffering from hepatocellular carcinoma(HCC)represented a debated issue.Halazun and colleagues pr...Since the adoption of Milan criteria more than 20 years ago,selection criteria for liver transplantation(LT)in patients suffering from hepatocellular carcinoma(HCC)represented a debated issue.Halazun and colleagues presented at the American Surgical Association of 2018,and published on the issue of October of Annals of Surgery,their results from an analysis aimed at including alpha-fetoprotein(AFP)in a model developed to predict long-term results after LT for HCC(1).Of 1,450 patients included between 2001 and 2013,16.2%were outside Milan criteria,61.1%were hepatitis C virus(HCV)positive and more than 80%of candidates received pre-LT locoregional therapies.Their study showed that incorporating AFP levels at diagnosis,maximum AFP(Max-AFP)at any time point,and the final immediate pre-transplant AFP(Final-AFP)to tumor number and diameter can well stratify different groups of patients at different risks of HCC recurrence after LT(NYCA model).展开更多
文摘Sorafenib has been considered the standard of care for patients with advanced unresectable hepatocellular carcinoma(HCC) since 2007 and numerous studieshave investigated the role of markers involved in the angiogenesis process at both the expression and genetic level and clinical aspect. What results have ten years of research produced? Several clinical and biological markers are associated with prognosis. The most interesting clinical parameters are adverse events, Barcelona Clinic Liver Cancer stage, and macroscopic vascular invasion, while several single nucleotide polymorphisms and plasma angiopoietin-2 levels represent the most promising biological biomarkers. A recent pooled analysis of two phase III randomized trials showed that the neutrophil-to-lymphocyte ratio, etiology and extra-hepatic spread are predictive factors of response to sorafenib, but did not identify any predictive biological markers. After 10 years of research into sorafenib there are still no validated prognostic or predictive factors of response to the drug in HCC. The aim of the present review was to summarize 10 years of research into sorafenib, looking in particular at the potential of associated clinical and biological markers to predict its efficacy in patients with advanced HCC.
文摘Since the adoption of Milan criteria more than 20 years ago,selection criteria for liver transplantation(LT)in patients suffering from hepatocellular carcinoma(HCC)represented a debated issue.Halazun and colleagues presented at the American Surgical Association of 2018,and published on the issue of October of Annals of Surgery,their results from an analysis aimed at including alpha-fetoprotein(AFP)in a model developed to predict long-term results after LT for HCC(1).Of 1,450 patients included between 2001 and 2013,16.2%were outside Milan criteria,61.1%were hepatitis C virus(HCV)positive and more than 80%of candidates received pre-LT locoregional therapies.Their study showed that incorporating AFP levels at diagnosis,maximum AFP(Max-AFP)at any time point,and the final immediate pre-transplant AFP(Final-AFP)to tumor number and diameter can well stratify different groups of patients at different risks of HCC recurrence after LT(NYCA model).