Leowattana W, Leowattana T, Leowattana P. Systemic treatment for unresectable hepatocellular carcinoma. World J Gastroenterol 2023; 29(10): 1551-1568 [PMID: 36970588 DOI: 10.3748/wjg.v29.i10.1551]
Corresponding Author of This Article
Wattana Leowattana, BMed, MD, MSc, PhD, Full Professor, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Rachatawee, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wattana Leowattana, PathompThep Leowattana, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Tawithep Leowattana, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Thailand
Author contributions: Leowattana W wrote the paper; Leowattana T and Leowattana P collected the data.
Conflict-of-interest statement: All the authors report no having relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wattana Leowattana, BMed, MD, MSc, PhD, Full Professor, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Rachatawee, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Received: September 27, 2022 Peer-review started: September 27, 2022 First decision: January 3, 2023 Revised: January 8, 2023 Accepted: February 22, 2023 Article in press: February 22, 2023 Published online: March 14, 2023 Processing time: 163 Days and 18.9 Hours
Core Tip
Core Tip: Hepatocellular carcinoma (HCC) is a major health problem that is the fourth leading cause of cancer-related mortality worldwide. The 5-year survival rate was nearly 19%, but only 2% in metastatic HCC. The first oral multikinase inhibitor for the systemic treatment of advanced or unresectable HCC (uHCC) was sorafenib. However, when compared to sorafenib, the combination of atezolizumab and bevacizumab increased survival rates and was authorized as first-line treatment for uHCC. Regorafenib and cabozantinib are suggested for use as second-line drugs in the event that the disease progresses. Transarterial chemoembolization for palliative care or downstaging is also suggested. This review focused on systemic therapy for uHCC patients who are not appropriate for liver-directed therapy.
