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Erschienen in: InFo Hämatologie + Onkologie 9/2021

21.09.2021 | Tyrosinkinaseinhibitoren | Schwerpunkt

Schwerpunkt "Primäre Lebertumoren"

Fortgeschrittenes HCC: Was sind die wirksamsten Systemtherapien?

verfasst von: Vera Himmelsbach, PD Dr. med. Fabian Finkelmeier, Prof. Dr. med. Oliver Waidmann

Erschienen in: InFo Hämatologie + Onkologie | Ausgabe 9/2021

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Zahlreiche neue Substanzen haben die systemische Therapie des hepatozellulären Karzinoms verändert. Neben Tyrosinkinasehemmern und antiangiogenen Substanzen stehen zunehmend auch immuntherapeutische Behandlungsoptionen zur Verfügung. Worin diese konkret bestehen, wann sie zum Einsatz kommen und worauf beim Nebenwirkungsmanagement zu achten ist, lesen Sie in dieser Übersicht.
Literatur
1.
Zurück zum Zitat Llovet JM et al. Sorafenib in Advanced Hepatocellular Carcinoma. N Engl J Med. 2008;359(4):378-90 Llovet JM et al. Sorafenib in Advanced Hepatocellular Carcinoma. N Engl J Med. 2008;359(4):378-90
2.
Zurück zum Zitat Kudo M et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018;391(10126):1163-73 Kudo M et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018;391(10126):1163-73
3.
Zurück zum Zitat Finn RS et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med. 2020;382(20):1894-1905 Finn RS et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med. 2020;382(20):1894-1905
4.
Zurück zum Zitat Abou-Alfa GK et al. Cabozantinib in Patients with Advanced and Progressing Hepatocellular Carcinoma. N Engl J Med. 2018;379(1):54-63 Abou-Alfa GK et al. Cabozantinib in Patients with Advanced and Progressing Hepatocellular Carcinoma. N Engl J Med. 2018;379(1):54-63
5.
Zurück zum Zitat Bruix J et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;389(10064):56-66 Bruix J et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;389(10064):56-66
6.
Zurück zum Zitat Zhu AX et al. REACH-2: A randomized, double-blind, placebo-controlled phase 3 study of ramucirumab versus placebo as second-line treatment in patients with advanced hepatocellular carcinoma (HCC) and elevated baseline alpha-fetoprotein (AFP) following first-line sorafenib. J Clin Oncol. 2018;36(15_suppl):4003 Zhu AX et al. REACH-2: A randomized, double-blind, placebo-controlled phase 3 study of ramucirumab versus placebo as second-line treatment in patients with advanced hepatocellular carcinoma (HCC) and elevated baseline alpha-fetoprotein (AFP) following first-line sorafenib. J Clin Oncol. 2018;36(15_suppl):4003
7.
Zurück zum Zitat Zhu AX et al. Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): a non-randomised, open-label phase 2 trial. Lancet Oncol. 2018;19(7):940-52 Zhu AX et al. Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): a non-randomised, open-label phase 2 trial. Lancet Oncol. 2018;19(7):940-52
8.
Zurück zum Zitat El-Khoueiry AB et al. Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. Lancet. 2017;389(10088):2492-502 El-Khoueiry AB et al. Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. Lancet. 2017;389(10088):2492-502
9.
Zurück zum Zitat Finn RS et al. KEYNOTE-240: Randomized phase III study of pembrolizumab versus best supportive care for second-line advanced hepatocellular carcinoma. J Clin Oncol. 2017;35(4_suppl):TPS503 Finn RS et al. KEYNOTE-240: Randomized phase III study of pembrolizumab versus best supportive care for second-line advanced hepatocellular carcinoma. J Clin Oncol. 2017;35(4_suppl):TPS503
10.
Zurück zum Zitat Yau T et al. CheckMate 459: A randomized, multi-center phase III study of nivolumab (NIVO) vs sorafenib (SOR) as first-line (1L) treatment in patients (pts) with advanced hepatocellular carcinoma (aHCC). Ann Oncol. 2019;30(suppl 5):v874-v875 Yau T et al. CheckMate 459: A randomized, multi-center phase III study of nivolumab (NIVO) vs sorafenib (SOR) as first-line (1L) treatment in patients (pts) with advanced hepatocellular carcinoma (aHCC). Ann Oncol. 2019;30(suppl 5):v874-v875
11.
Zurück zum Zitat Yau T et al. Nivolumab (NIVO) + ipilimumab (IPI) combination therapy in patients (pts) with advanced hepatocellular carcinoma (aHCC): Results from CheckMate 040. J Clin Oncol. 2019;37(15_suppl):4012 Yau T et al. Nivolumab (NIVO) + ipilimumab (IPI) combination therapy in patients (pts) with advanced hepatocellular carcinoma (aHCC): Results from CheckMate 040. J Clin Oncol. 2019;37(15_suppl):4012
12.
Zurück zum Zitat Villanueva A. Hepatocellular Carcinoma. N Engl J Med. 2019;380(15):1450-62 Villanueva A. Hepatocellular Carcinoma. N Engl J Med. 2019;380(15):1450-62
13.
Zurück zum Zitat Llovet JM et al. Hepatocellular carcinoma. Nat Rev Dis Prim. 2021;7(1):6 Llovet JM et al. Hepatocellular carcinoma. Nat Rev Dis Prim. 2021;7(1):6
14.
Zurück zum Zitat Llovet JM et al. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19(3):329-38 Llovet JM et al. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19(3):329-38
15.
Zurück zum Zitat Galle PR et al. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236 Galle PR et al. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236
16.
Zurück zum Zitat Marrero JA et al. Observational registry of sorafenib use in clinical practice across Child-Pugh subgroups: The GIDEON study. J Hepatol. 2016;65(6):1140-7 Marrero JA et al. Observational registry of sorafenib use in clinical practice across Child-Pugh subgroups: The GIDEON study. J Hepatol. 2016;65(6):1140-7
17.
Zurück zum Zitat Zhu AX et al. Ramucirumab as second-line treatment in patients with advanced hepatocellular carcinoma analysis of REACH trial results by child-pugh score. JAMA Oncol. 2017;3(2):235-43 Zhu AX et al. Ramucirumab as second-line treatment in patients with advanced hepatocellular carcinoma analysis of REACH trial results by child-pugh score. JAMA Oncol. 2017;3(2):235-43
18.
Zurück zum Zitat Finkelmeier F et al. Nivolumab for the treatment of hepatocellular carcinoma. Expert Rev Anticancer Ther. 2018;18(12):1169-75 Finkelmeier F et al. Nivolumab for the treatment of hepatocellular carcinoma. Expert Rev Anticancer Ther. 2018;18(12):1169-75
19.
Zurück zum Zitat Kudo M et al. Randomised, multicentre prospective trial of transarterial chemoembolisation (TACE) plus sorafenib as compared with TACE alone in patients with hepatocellular carcinoma: TACTICS trial. Gut. 2020;69(8):1492-1501 Kudo M et al. Randomised, multicentre prospective trial of transarterial chemoembolisation (TACE) plus sorafenib as compared with TACE alone in patients with hepatocellular carcinoma: TACTICS trial. Gut. 2020;69(8):1492-1501
20.
Zurück zum Zitat Lencioni R et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate stage HCC: The SPACE trial. J Hepatol. 2016;64(5):1090-8 Lencioni R et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate stage HCC: The SPACE trial. J Hepatol. 2016;64(5):1090-8
21.
Zurück zum Zitat Casadei-Gardini A et al. Lenvatinib versus sorafenib in first-line treatment of unresectable hepatocellular carcinoma: An inverse probability of treatment weighting analysis. Liver Int. 2021;41(6):1389-97 Casadei-Gardini A et al. Lenvatinib versus sorafenib in first-line treatment of unresectable hepatocellular carcinoma: An inverse probability of treatment weighting analysis. Liver Int. 2021;41(6):1389-97
22.
Zurück zum Zitat Finn RS et al. IMbrave150: Updated overall survival (OS) data from a global, randomized, open-label phase III study of atezolizumab (atezo) + bevacizumab (bev) versus sorafenib (sor) in patients (pts) with unresectable hepatocellular carcinoma (HCC). J Clin Oncol. 2021;39(3_suppl):267 Finn RS et al. IMbrave150: Updated overall survival (OS) data from a global, randomized, open-label phase III study of atezolizumab (atezo) + bevacizumab (bev) versus sorafenib (sor) in patients (pts) with unresectable hepatocellular carcinoma (HCC). J Clin Oncol. 2021;39(3_suppl):267
23.
Zurück zum Zitat Galle PR et al. Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(7):991-1001 Galle PR et al. Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(7):991-1001
24.
Zurück zum Zitat Pinter M et al. Immunotherapy for advanced hepatocellular carcinoma: A focus on special subgroups. Gut. 2021 ;70(1):204-14 Pinter M et al. Immunotherapy for advanced hepatocellular carcinoma: A focus on special subgroups. Gut. 2021 ;70(1):204-14
26.
Zurück zum Zitat Vogel A et al. Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(suppl 4):iv238-iv255 Vogel A et al. Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(suppl 4):iv238-iv255
27.
Zurück zum Zitat Finkelmeier F et al. Cabozantinib in Advanced Hepatocellular Carcinoma: Efficacy and Safety Data from an International Multicenter Real-Life Cohort. Liver Cancer. 2021;10(4):360-9 Finkelmeier F et al. Cabozantinib in Advanced Hepatocellular Carcinoma: Efficacy and Safety Data from an International Multicenter Real-Life Cohort. Liver Cancer. 2021;10(4):360-9
28.
Zurück zum Zitat Tovoli F et al. Real-Life Clinical Data of Cabozantinib for Unresectable Hepatocellular Carcinoma. Liver Cancer. 2021;10(4):370-9 Tovoli F et al. Real-Life Clinical Data of Cabozantinib for Unresectable Hepatocellular Carcinoma. Liver Cancer. 2021;10(4):370-9
29.
Zurück zum Zitat Galle PR et al. Patient-reported outcomes (PROs) from the Phase III IMbrave150 trial of atezolizumab (atezo) + bevacizumab (bev) vs sorafenib (sor) as first-line treatment (tx) for patients (pts) with unresectable hepatocellular carcinoma (HCC). J Clin Oncol. 2020;38(suppl 4):476 Galle PR et al. Patient-reported outcomes (PROs) from the Phase III IMbrave150 trial of atezolizumab (atezo) + bevacizumab (bev) vs sorafenib (sor) as first-line treatment (tx) for patients (pts) with unresectable hepatocellular carcinoma (HCC). J Clin Oncol. 2020;38(suppl 4):476
30.
Zurück zum Zitat Pinter M et al. The Current Landscape of Immune Checkpoint Blockade in Hepatocellular Carcinoma: A Review. JAMA Oncol. 2021;7(1):113-23 Pinter M et al. The Current Landscape of Immune Checkpoint Blockade in Hepatocellular Carcinoma: A Review. JAMA Oncol. 2021;7(1):113-23
31.
Zurück zum Zitat Haanen JBAG et al. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl 4):iv119-iv142 Haanen JBAG et al. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl 4):iv119-iv142
33.
Zurück zum Zitat Pfister D et al. NASH Limits Anti-Tumour Surveillance in Immunotherapy-Treated HCC. Nature. 2021;592(7854):450-6 Pfister D et al. NASH Limits Anti-Tumour Surveillance in Immunotherapy-Treated HCC. Nature. 2021;592(7854):450-6
34.
Zurück zum Zitat Bangaru S et al. Review article: new therapeutic interventions for advanced hepatocellular carcinoma. Aliment Pharmacol Ther. 2020;51(1):78-89 Bangaru S et al. Review article: new therapeutic interventions for advanced hepatocellular carcinoma. Aliment Pharmacol Ther. 2020;51(1):78-89
35.
Zurück zum Zitat Kirstein MM et al. Sequential systemic treatment in patients with hepatocellular carcinoma. Aliment Pharmacol Ther. 2020;52(1):205-12 Kirstein MM et al. Sequential systemic treatment in patients with hepatocellular carcinoma. Aliment Pharmacol Ther. 2020;52(1):205-12
Metadaten
Titel
Schwerpunkt "Primäre Lebertumoren"
Fortgeschrittenes HCC: Was sind die wirksamsten Systemtherapien?
verfasst von
Vera Himmelsbach
PD Dr. med. Fabian Finkelmeier
Prof. Dr. med. Oliver Waidmann
Publikationsdatum
21.09.2021
Verlag
Springer Medizin
Erschienen in
InFo Hämatologie + Onkologie / Ausgabe 9/2021
Print ISSN: 2662-1754
Elektronische ISSN: 2662-1762
DOI
https://doi.org/10.1007/s15004-021-8778-4

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