title: Hepatocellular carcinoma: Will novel targeted drugs really impact the next future?
abstract: Cancer treatment has been revolutionized by the advent of new molecular targeted and immunotherapeutic agents. Identification of the role of tumor angiogenesis changed the understanding of many tumors. After the unsuccessful results with chemotherapy, sorafenib, by interfering with angiogenic pathways, has become pivotal in the treatment of hepatocellular carcinoma. Sorafenib is the only systemic treatment to show a modest but statistically significant survival benefit. All novel drugs and strategies for treatment of advanced hepatocellular carcinoma must be compared with the results obtained with sorafenib, but no new drug or drug combination has yet achieved better results. In our opinion, the efforts to impact the natural history of the disease will be directed not only to drug development but also to understanding the underlying liver disease (usually hepatitis B virus- or hepatitis C virus-related) and to interrupting the progression of cirrhosis. It will be important to define the role and amount of mutations in the complex pathogenesis of hepatocellular carcinoma and to better integrate locoregional and systemic therapies. It will be important also to optimize the therapeutic strategies with existing chemotherapeutic drugs and new targeted agents.
authors.affiliation: Liliana Montella, Raffaele Addeo, Salvatore Del Prete, Medical Oncology Unit, "San Giovanni di Dio" Hospital, Frattamaggiore, 80027 Naples, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Montella
authors.affiliation: Liliana Montella, Raffaele Addeo, Salvatore Del Prete, Medical Oncology Unit, "San Giovanni di Dio" Hospital, Frattamaggiore, 80027 Naples, Italy.
authors.forename: Giovannella
authors.initials: G
authors.lastname: Palmieri
authors.affiliation: Liliana Montella, Raffaele Addeo, Salvatore Del Prete, Medical Oncology Unit, "San Giovanni di Dio" Hospital, Frattamaggiore, 80027 Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Addeo
authors.affiliation: Liliana Montella, Raffaele Addeo, Salvatore Del Prete, Medical Oncology Unit, "San Giovanni di Dio" Hospital, Frattamaggiore, 80027 Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Del Prete
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D055808:Drug Discovery; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D020929:Mitogen-Activated Protein Kinase Kinases / Q000037:antagonists & inhibitors; D058990:Molecular Targeted Therapy; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D019859:Proto-Oncogene Proteins c-met / Q000037:antagonists & inhibitors; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D000077157:Sorafenib; D042442:Vascular Endothelial Growth Factors / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D042442:Vascular Endothelial Growth Factors; D009536:Niacinamide; D000077157:Sorafenib; D066246:ErbB Receptors; C491743:MET protein, human; D019859:Proto-Oncogene Proteins c-met; D040262:Receptors, Vascular Endothelial Growth Factor; D020929:Mitogen-Activated Protein Kinase Kinases
keywords: Angiogenesis; Hepatocellular carcinoma; Pathway; Sorafenib; Targeted therapy