Please use this identifier to cite or link to this item: https://ir.swu.ac.th/jspui/handle/123456789/29343
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dc.contributor.authorLeowattana W.
dc.contributor.authorLeowattana T.
dc.contributor.authorLeowattana P.
dc.contributor.otherSrinakharinwirot University
dc.date.accessioned2023-11-15T02:08:19Z-
dc.date.available2023-11-15T02:08:19Z-
dc.date.issued2023
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85151042744&doi=10.3748%2fwjg.v29.i10.1551&partnerID=40&md5=8259e6f746fa024dadbd8e6d1d2c07a8
dc.identifier.urihttps://ir.swu.ac.th/jspui/handle/123456789/29343-
dc.description.abstractHepatocellular carcinoma (HCC) is most commonly found in the context of liver cirrhosis and, in rare cases, in a healthy liver. Its prevalence has risen in recent years, particularly in Western nations, due to the increasing frequency of nonalcoholic fatty liver disease. Advanced HCC has a poor prognosis. For many years, the only proven therapy for unresectable HCC (uHCC) was sorafenib, a tyrosine kinase inhibitor. Recently, the synergistic effect of an immune checkpoint inhibitor, atezolizumab, and bevacizumab outperformed sorafenib alone in terms of survival, making it the recommended first-line therapy. Other multikinase inhibitors, lenvatinib and regorafenib, were also recommended as first and second-line drugs, respectively. Intermediate-stage HCC patients with retained liver function, particularly uHCC without extrahepatic metastasis, may benefit from trans-arterial chemoembolization. The current problem in uHCC is selecting a patient for the best treatment while considering the preexisting liver condition and liver function. Indeed, all study patients had a Child-Pugh class A, and the best therapy for other individuals is unknown. Additionally, in the absence of a medical contraindication, atezolizumab could be combined with bevacizumab for uHCC systemic therapy. Several studies are now underway to evaluate immune checkpoint inhibitors in combination with anti-angiogenic drugs, and the first findings are encouraging. The paradigm of uHCC therapy is changing dramatically, and many obstacles remain for optimum patient management in the near future. The purpose of this commentary review was to give an insight into current systemic treatment options for patients with uHCC who are not candidates for surgery to cure the disease. ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
dc.publisherBaishideng Publishing Group Inc
dc.subjectAtezolizumab
dc.subjectBevacizumab
dc.subjectHepatocellular carcinoma
dc.subjectImmune checkpoint inhibitor
dc.subjectLenvatinib
dc.subjectNonalcoholic fatty liver disease
dc.subjectSorafenib
dc.subjectTyrosine kinase inhibitor
dc.subjectUnresectable hepatocellular carcinoma
dc.titleSystemic treatment for unresectable hepatocellular carcinoma
dc.typeReview
dc.rights.holderScopus
dc.identifier.bibliograpycitationWorld Journal of Gastroenterology. Vol 29, No.10 (2023), p.1551-1568
dc.identifier.doi10.3748/wjg.v29.i10.1551
Appears in Collections:Scopus 2023

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