Effective treatment for hepatocellular carcinoma is desperately needed because it is a deadly disease whose worldwide annual incidence matches its prevalence and is the fifth leading cause of cancer death worldwide. The mainstay of management of HCC is early diagnosis with the hope of applying curative therapy. It is estimated that with the application of current surveillance modalities, only, 30%-40% of cases could be diagnosed early enough for curative treatments.
Given the limited efficacy of adjuvant and palliative treatment options to date, there has been an extensive effort to identify other agents useful for the management of HCC. Systemic chemotherapy has largely been disappointing in terms of palliation or cure. Cytotoxic chemotherapy has been shown to provide no survival benefit.
Sorafenib, a tyrosine-kinase inhibitor, is widely used in the treatment of advanced hepatocellular carcinoma. In 2007, Llovet and colleagues first reported the results of the international, phase III, placebo-controlled Sorafenib HCC Assessment Randomized Protocol (SHARP) trial, which demonstrated a longer overall survival (OS) time and time to tumor progression (TTP), compared to placebo in patients with advanced hepatocellular carcinoma
The development of sorafenib in HCC has several important implications. First, it validates the use of molecularly targeted agents in HCC. Second, it sets a new standard for ongoing and future clinical trials in advanced HCC. A Clinical Phase II Study of Sorafenib in Advanced Hepatocellular Carcinoma; Hanan Shawky Gamal El Deen and Emad Abd-Elmongy Sadaka
Last date updated on June, 2014