Targeted therapy and personalized medicine in hepatocellular carcinoma: drug resistance, mechanisms, and treatment strategies

Hepatocellular carcinoma (HCC) is characterized by a growing number of new cases diagnosed each year that is nearly equal to the number of deaths from this cancer. In a majority of the cases, HCC is associated with the underlying chronic liver disease, and it is diagnosed in advanced stage of diseas...

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Bibliographic Details
Published inJournal of hepatocellular carcinoma Vol. 4; pp. 93 - 103
Main Authors Galun, Danijel, Srdic-Rajic, Tatjana, Bogdanovic, Aleksandar, Loncar, Zlatibor, Zuvela, Marinko
Format Journal Article
LanguageEnglish
Published New Zealand Taylor & Francis Ltd 01.01.2017
Dove Medical Press
Subjects
Cancer therapies
Cell cycle
Chemotherapy
DNA damage
Drug resistance
Gene expression
Hepatitis
hepatocellular carcinoma
Hepatology
Hypoxia
Infections
Kinases
Liver cancer
Liver diseases
Medical prognosis
Metabolism
MicroRNAs
multimodal treatment
Oncology
Patients
Precision medicine
Review
Studies
Serbia
United States > US
multimodal treatment
drug resistance
chemotherapy
hepatocellular carcinoma
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Summary:Hepatocellular carcinoma (HCC) is characterized by a growing number of new cases diagnosed each year that is nearly equal to the number of deaths from this cancer. In a majority of the cases, HCC is associated with the underlying chronic liver disease, and it is diagnosed in advanced stage of disease when curative treatment options are not applicable. Sorafenib is a treatment of choice for patients with performance status 1 or 2 and/or macrovascular invasion or extrahepatic spread, and regorafenib is the only systemic treatment found to provide survival benefit in HCC patients progressing on sorafenib treatment. Other drugs tested in different trials failed to demonstrate any benefit. Disappointing results of numerous trials testing the efficacy of various drugs indicate that HCC has low sensitivity to chemotherapy that is in great part caused by multidrug resistance. Immunotherapy for HCC is a new challenging treatment option and involves immune checkpoint inhibitors/antibody-based therapy and peptide-based vaccines. Another challenging approach is microRNA-based therapy that involves two strategies. The first aims to inhibit oncogenic miRNAs by using miRNA antagonists and the second strategy is miRNA replacement, which involves the reintroduction of a tumor-suppressor miRNA mimetic to restore a loss of function.
Bibliography:ObjectType-Article-2
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ISSN:2253-5969
2253-5969
DOI:10.2147/jhc.s106529