Current Treatment Options for HCC: From Pharmacokinetics to Efficacy and Adverse Events in Liver Cirrhosis.

Abstract:

BACKGROUND:Hepatocellular carcinoma (HCC) is among the world's most common cancers. For over ten years, the only medical treatment for it has been the multikinase inhibitor Sorafenib. Currently, however, other first or second-line therapeutic options have also shown efficacy against HCC, such as multikinase inhibitors (Regorafenib, Lenvatinib, and Cabozantinib), a monoclonal antibody against the vascular endothelial growth factor receptor 2 (Ramucirumab), and immune-checkpoint inhibitors (Nivolumab, Pembrolizumab, Ipilimumab). AIM:The aim of this paper is to review the metabolic pathways of drugs that have been tested for the treatment of HCC and the potential influence of liver failure over those pathways. METHODS:The Food and Drug Administration (FDA)'s and European Medicines Agency (EMA)'s datasheets, results from clinical trials and observational studies have been reviewed. RESULTS:This review summarizes the current knowledge regarding targets, metabolic pathways, drug interactions, and adverse events of medical treatments for HCC in cirrhotic patients. CONCLUSION:The new scenario of systemic HCC therapy includes more active drugs with different metabolic pathways and different liver adverse events. Clinical and pharmacological studies providing more data on the safety of these molecules are urgently needed.

journal_name

Curr Drug Metab

journal_title

Current drug metabolism

authors

Galati G,Massimo Vainieri AF,Maria Fulgenzi CA,Di Donato S,Silletta M,Gallo P,Onorato A,Vespasiani-Gentilucci U,Picardi A

doi

10.2174/1389200221999200918141239

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

866-884

issue

11

eissn

1389-2002

issn

1875-5453

pii

CDM-EPUB-110084

journal_volume

21

pub_type

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