title: Hepatocellular carcinoma: insights in the biological treatment beyond sorafenib.
abstract: Hepatocellular carcinoma has an increasing incidence and an impressive mortality. At present, the only authorized systemic treatment is the multi-kinase inhibitor sorafenib. A multitude of clinical trials are aimed at improving outcomes, both in firstY- and in second-line therapy. In this multitude of clinical trials, the purpose of our article was to familiarize physicians with the mechanisms of action of new biological therapies and to offer an algorithm for optimal trial selection for each patient, based on clinical and biological indicators. The available data were structured as follows: antiangiogenic therapy, c -MET inhibitors, combinations of chemotherapy with sorafenib, immune response modulators, cellular metabolism modulators, mTOR inhibitors, other multi-kinase inhibitors.
  
  
  CONCLUSIONS
  Treatment of advanced hepatocellular carcinoma remains a challenge for oncologists. Choosing the "right" trial may be the only chance of prolonging patient survival and improve his/her clinical status.
authors.affiliation: The University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Gafton
authors.forename: Vlad
authors.initials: V
authors.lastname: Porumb
authors.forename: Simona
authors.initials: S
authors.lastname: Ungurianu
authors.forename: Mihai Vasile
authors.initials: MV
authors.lastname: Marinca
authors.forename: Corina
authors.initials: C
authors.lastname: Cocea
authors.forename: Adina
authors.initials: A
authors.lastname: Croitoru
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Balan
authors.forename: Nicolae
authors.initials: N
authors.lastname: Miron
authors.forename: Tudor
authors.initials: T
authors.lastname: Eliade Ciuleanu
authors.forename: Lucian
authors.initials: L
authors.lastname: Miron
mesh_terms: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D001691:Biological Therapy; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors