These new therapies for liver cancer must be known!

These new therapies for liver cancer must be known if Missed prevention and screening! Since liver cancer has no obvious symptoms in the early stage, it is found to be in the middle and late stages as soon as the examination is found, which brings great difficulty to the treatment.

If liver cancer is in the middle and advanced stages and the opportunity for surgery is lost, is there really no hope?

In fact, in recent years, many breakthroughs have been made in the field of liver cancer treatment, especially in targeted therapy and immunotherapy, which have brought new hope to patients. Even if surgery is not possible, new treatments can be used to prolong survival and improve the quality of life.

▌Targeted therapy for liver cancer

Targeted therapy is like a “scud missile” that can accurately attack tumors without harming other normal cells of our body. Compared with chemotherapy, side effects are more controllable.

▲ First-line targeted drugs for liver cancer

Sorafenib: the world’s first targeted drug

As early as 2005, Sorafenib was approved by the FDA for marketing and was the first anti-angiogenic drug targeting liver cancer.

In 2007, sorafenib was approved for marketing in China as the first-line treatment for patients with advanced liver cancer.

However, although the drug can extend the median survival of patients by 2 to 3 months, most patients will develop resistance within half a year of treatment. Therefore, the benefits of liver cancer patients are relatively limited, and the need for new therapies is imminent.

Lenvatinib: better efficacy

In August 2018, the FDA approved Lenvatinib (Lenvatinib, Lenvima) for the first-line treatment of unresectable hepatocellular carcinoma.

Lenvatinib is a multi-target kinase inhibitor. The main targets include VEGFR-1, VEGFR-2, VEGFR-3, FGFR1, PDGFR, cKit, Ret, etc. So far, it has been approved for multiple adaptations in the United States Symptoms, such as liver cancer, thyroid cancer, and advanced renal cell carcinoma.

It is worth mentioning that today, with the official launch of the new version of the “Medical Insurance Drug Catalog” in 2020, the price of lenvatinib medical insurance has been reduced by as much as 80.7%, which means that more Chinese liver cancer patients can afford good medicine.

▲ Second-line targeted drugs

Rigofinil: has been covered by medical insurance

In 2017, Regorafenib (Trade name: Stivarga) was approved for Sorafenib-resistant patients with advanced hepatocellular carcinoma.

Regorafenib is a multi-kinase inhibitor that can act on KIT, RET, PDGFR, BRAF, VEGFR1/2/3, FGFR, etc. At present, the drug has entered some countries’s medical insurance, with a drop rate of 45.56%.

Cabozantinib: the “universal drug” in targeted drugs

Cabozantinib is a multi-target small molecule tyrosine kinase inhibitor, which can act on nine targets of MET, VEGFR1 2 3, ROS1, RET, AXL, NTRK, and KIT. Due to its wide range of effects and its effectiveness on a variety of tumors, cabozantinib is known as the “magic oil” in targeted drugs.

In 2018, the FDA approved cabozantinib tablets for the treatment of patients with advanced hepatocellular carcinoma who have progressed after receiving sorafenib or other standard systemic treatments.

Remucirumab: Single-drug treatment for patients with liver cancer

In May 2019, Ramucirumab (Ramucirumab, Cyramza) was approved by the FDA as a second-line monotherapy for the treatment of liver cancer patients with alpha-fetoprotein (AFP) ≥400ng/ML and resistance to sorafenib.

Ramucirumab is a human vascular endothelial growth factor receptor 2 (VEGFR2) antagonist. It can specifically bind to VEGFR2, thereby inhibiting vascular proliferation and preventing tumors from growing or spreading further.

The approval of second-line drugs has ended the plight of no drugs available after first-line treatments are resistant, giving liver cancer patients new hope for treatment.

▌Immunotherapy

Immunotherapy is not aimed at tumors but the own immune system. By activating the immune system’s ability to recognize and kill tumors, it can achieve anti-cancer effects. At present, the most popular immunotherapy drugs are PD-1/PD-L1 immune checkpoint inhibitors, which brings new opportunities for liver cancer treatment.

Two drugs successively approved

In 2017, the FDA approved the “O drug” nivolumab for the market for liver cancer patients who had previously been treated with sorafenib (second-line treatment). This is the first immune checkpoint inhibitor approved for the treatment of liver cancer. This has overcome the long-standing limitations of treatment for liver cancer.

In 2018, the “K drug” pembrolizumab was approved for a new indication for hepatocellular carcinoma patients who had previously been treated with sorafenib (second-line treatment).

In addition, at the 2020 ASCO annual meeting, new research shows that the combination of pembrolizumab and lenvatinib can improve the remission rate of patients with unresectable liver cancer. Currently, the therapy is under accelerated approval.

Double immune combination

In March 2020, the FDA approved the PD-1 inhibitor “O drug” nivolumab to be used in combination with the CTLA-4 inhibitor “Y drug” ipilimumab to treat patients who have previously received sorafenib treatment Patients with hepatocellular carcinoma. This is the first dual immunotherapy approved by the FDA.

Immunotherapy for liver cancer

In May 2020, the FDA approved the anti-PD-L1 therapy “T drug” atelizumab combined with “A drug” bevacizumab as the first-line treatment for patients with unresectable hepatocellular carcinoma.

The “T+A” combination therapy is the first and only immunotherapy program approved for the treatment of unresectable liver cancer.

At present, the joint program has also been approved in China, and has become the first choice for inoperable hepatocellular carcinoma patients with better liver function.

In addition, the efficacy of other immunotherapies for the treatment of liver cancer is also in clinical trials, such as tislelizumab, sintilizumab, teriplizumab, “D+T” dual immunotherapy, and a new generation of immunoimmunotherapy M7824, etc., expect these drugs to further improve the survival time of liver cancer patients.

Dr. Michael Castro, an expert on tumor precision medicine (who has been awarded the “Top Doctors in the United States” for many years), said that at present, advanced liver cancer is incurable but still treatable.

The treatment of liver cancer mainly includes: surgical treatment (surgical resection, liver transplantation), radiotherapy, chemotherapy, interventional therapy (including: yttrium 90 microspheres), targeted therapy, immunotherapy, tumor microenvironment therapy, etc.

In view of the complexity of liver cancer, a comprehensive treatment plan and multidisciplinary assisted diagnosis and treatment model (MDT) are essential for the treatment of liver cancer. Patients with advanced liver cancer cannot do without a team of multidisciplinary experts to jointly formulate the most suitable personalized comprehensive diagnosis and treatment plan for them.

Experts remind:

At present, the most effective way to deal with liver cancer is still the “three early”: early prevention, early screening, and early treatment. Early liver cancer surgery is the first choice, and many patients can even achieve long-term survival.

As for patients with advanced liver cancer, through authoritative experts at home and abroad to formulate the best treatment plan, they also have the opportunity to benefit from the global cutting-edge medical results and regain hope of treatment.

(source:internet, reference only)

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