What is targeted therapy?
Targeted therapy in hepatocellular carcinoma refers to therapies that target cellular signaling and other biological pathways involved in the development of hepatocellular carcinoma. There are three levels of targeted therapy: organ-targeted, cell-targeted, and molecular-targeted.
Molecularly targeted drugs specifically inhibit tumor growth and tumor neovascularization at the molecular level by targeting the genes that drive tumorigenesis and progression. Molecularly targeted therapies explicitly target tumor cells, have less impact on normal cells, and are stable, precise, and aggressive.
Molecularly targeted drugs for hepatocellular carcinoma
Molecularly targeted drugs are the highest level of targeted therapy. So, what are those molecularly targeted drugs for liver cancer?
Sorafenib
Sorafenib is the first molecularly targeted drug supported by evidence from phase III clinical studies and approved by the US FDA and the Chinese Food and Drug Administration for hepatocellular carcinoma that is inoperable or has distant metastases.
Sorafenib is currently the first-line standard of care for progressive hepatocellular carcinoma and an important option in combination therapy regimens for intermediate-stage hepatocellular carcinoma.
Sorafenib achieves tumor growth inhibition through a dual mechanism of action:
- Directly inhibits tumor cell proliferation by blocking relevant signaling pathways;
- Indirectly inhibits tumor growth by inhibiting tumor neovascularization and altering the interstitial environment of tumors, and also reduces tumor recurrence and metastasis.
Lenvatinib (lenvatinib)
With the successful development of sorafenib, the treatment of hepatocellular carcinoma has entered a new era, and clinical studies of new molecularly targeted drugs for hepatocellular carcinoma are in full swing.
According to the current study, another molecularly targeted drug, levatinib, was also shown to be as effective as sorafenib in a phase III study and was approved for marketing in China in September 2018, giving liver cancer patients another first-line treatment option.
Regofenib
Regorafenib is the first second-line agent proven to be effective after phase III clinical studies for patients with hepatocellular carcinoma progression after sorafenib treatment, and it is now available in China.
However, the adverse effects of regorafenib are similar to those of sorafenib, so it is not recommended for patients who cannot tolerate sorafenib.