6533b82dfe1ef96bd1290a4e
RESEARCH PRODUCT
Systemic treatment of HCC in special populations
Carolin CzaudernaCarolin CzaudernaFriedrich FoersterLorenza RimassaPeter R. GalleNicola Personenisubject
0301 basic medicinemedicine.medical_specialtyCarcinoma Hepatocellularmedicine.medical_treatmentComorbidityDisease03 medical and health sciences0302 clinical medicineDiabetes mellitusInternal medicinemedicineHumansMultiple Chronic ConditionsAutoimmune diseaseHepatologybusiness.industryLiver NeoplasmsConfoundingDisease ManagementImmunotherapymedicine.diseasedigestive system diseasesPortal vein thrombosis030104 developmental biologyHepatocellular carcinoma030211 gastroenterology & hepatologyMetabolic syndromebusinessdescription
Summary Recent years have seen significant progress in the systemic treatment of hepatocellular carcinoma (HCC), including the advent of immunotherapy. While several large phase III trials have provided the evidence for a multi-line treatment paradigm, they have focused on a highly selected group of patients by excluding potentially confounding comorbidities. As a result, high quality evidence for the systemic treatment of HCC in patients with various comorbidities is missing. This review summarises current knowledge on the use of approved medicines in patients with HIV, autoimmune disease, cardiovascular disease, diabetes, fibrolamellar HCC, mixed HCC-cholangiocarcinoma, decompensated cirrhosis (Child-Pugh B and C), a significant bleeding history, vascular invasion or portal vein thrombosis, as well as the elderly, those on haemodialysis, and those after solid organ transplantation. The article highlights relevant knowledge gaps and current clinical challenges. To improve the safety and efficacy of HCC treatment in these subgroups, future trials should be designed to specifically include patients with comorbidities.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-08-27 | Journal of Hepatology |