TY - JOUR
T1 - Neoadjuvant and adjuvant treatment approaches for hepatocellular carcinoma
T2 - Future outlook
AU - Sahin, Ibrahim Halil
AU - Khalil, Lana
AU - Millett, Ralph
AU - Kaseb, Ahmed
N1 - Publisher Copyright:
© 2021 AME Publishing Company. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Hepatocellular carcinoma (HCC) is a highly aggressive and chemotherapy resistant cancer with unique biologic characteristics which makes this disease highly different than other gastrointestinal cancers. The mainstay of curative treatment in HCC is surgical resection, ablation, and transplantation. However, rates of recurrence are high and many patients are not initially candidates for these curative approaches. This paper discusses predictors of recurrence of HCC in patients who have undergone surgical resection and addresses adjuvant therapies aimed at decreasing recurrence risk and improving overall survival (OS) outcomes, including traditional cytotoxic chemotherapies, tyrosine kinase inhibitors (TKIs), and immunotherapy. This article also discusses neoadjuvant strategies aimed at improving recurrence rate and OS as well as downstaging advanced HCC to enable surgical disease, including locoregional therapies, systemic chemotherapy, TKIs, and immune checkpoint inhibitors. Finally, this article addresses potential future directions for both adjuvant and neoadjuvant therapies that may change the treatment paradigm of HCC in the near future.
AB - Hepatocellular carcinoma (HCC) is a highly aggressive and chemotherapy resistant cancer with unique biologic characteristics which makes this disease highly different than other gastrointestinal cancers. The mainstay of curative treatment in HCC is surgical resection, ablation, and transplantation. However, rates of recurrence are high and many patients are not initially candidates for these curative approaches. This paper discusses predictors of recurrence of HCC in patients who have undergone surgical resection and addresses adjuvant therapies aimed at decreasing recurrence risk and improving overall survival (OS) outcomes, including traditional cytotoxic chemotherapies, tyrosine kinase inhibitors (TKIs), and immunotherapy. This article also discusses neoadjuvant strategies aimed at improving recurrence rate and OS as well as downstaging advanced HCC to enable surgical disease, including locoregional therapies, systemic chemotherapy, TKIs, and immune checkpoint inhibitors. Finally, this article addresses potential future directions for both adjuvant and neoadjuvant therapies that may change the treatment paradigm of HCC in the near future.
KW - Adjuvant treatment
KW - Hepatocellular carcinoma (HCC)
KW - Neoadjuvant treatment
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U2 - 10.21037/CCO-20-248
DO - 10.21037/CCO-20-248
M3 - Review article
C2 - 33440948
AN - SCOPUS:85100638372
SN - 2304-3865
VL - 10
JO - Chinese clinical oncology
JF - Chinese clinical oncology
IS - 1
M1 - 7
ER -