Published online Aug 18, 2015. doi: 10.4254/wjh.v7.i17.2053
Peer-review started: February 25, 2015
First decision: June 3, 2015
Revised: June 22, 2015
Accepted: June 30, 2015
Article in press: July 2, 2015
Published online: August 18, 2015
Processing time: 178 Days and 18.9 Hours
Hepatocellular carcinoma (HCC) is the main cause of death in patients with cirrhosis, with an increasing incidence worldwide. Sorafenib is the choice therapy for advanced HCC. Over time several randomized phase III trials have been performed testing sunitinib, brivanib, linifanib and other molecules in head-to-head comparison with Sorafenib as first-line treatment for advanced-stage HCC, but none of these has so far been registered in this setting. Moreover, another feared vacuum arises from the absence of molecules registered as second-line therapy for patients who have failed Sorafenib, representing an urgent unmet medical need. To date all molecules tested as second-line therapies for advanced hepatocellular carcinoma, failed to demonstrate an increased survival compared to placebo. What are the possible reasons for the failure? What we should expect in the near future?
Core tip: Hepatocellular carcinoma (HCC) is the main cause of death in patients with cirrhosis with an increasing incidence worldwide. Sorafenib is the choice therapy for advanced HCC. Since then no other molecule has been registered as first-line therapy in this setting and one more vacuum arises from the absence of molecules registered as second-line therapy for patients who have failed Sorafenib. What are the reasons and what we should expect in the near future?