アブストラクト
| Title | 4 肝細胞がん 1) 薬物療法 |
|---|---|
| Subtitle | 特集 消化器がんの内科的治療法の進歩 |
| Authors | 古瀬純司 |
| Authors (kana) | ふるせじゅんじ |
| Organization | 杏林大学医学部腫瘍内科学教室 教授 |
| Journal | THE GI FOREFRONT |
| Volume | 16 |
| Number | 2 |
| Page | 114-117 |
| Year/Month | 2020 / 12 |
| Article | 報告 |
| Publisher | メディカルレビュー社 |
| Abstract | 肝細胞がんに対する薬物療法は, 切除手術, 局所壊死療法や肝動脈化学塞栓療法 (transcatheter arterial chemoembolization : TACE) など局所治療が適応にならない進行がんが対象となる. まずマルチキナーゼ阻害薬ソラフェニブにより初めて標準治療が確立した. その後, ソラフェニブとの比較試験により, レンバチニブおよびアテゾリズマブ+ベバシズマブ併用療法の有用性が確認されている. 二次以降の治療としてレゴラフェニブ, ラムシルマブが現在使用され, カボザンチニブも申請中である. さらに根治治療後の補助療法やTACEとの併用で大規模な臨床試験が進められている. 肝細胞がんは薬物療法による予後の改善が見込まれるとともに, これらの薬剤をどのように使用していくかが臨床的課題となるものと考えられる. |
| Practice | 臨床医学：内科系 |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に913円(税込) です。
参考文献
- 1) 日本肝臓学会(編). 治療アルゴリズム. 肝癌診療ガイドライン. 2017年版補訂版. 東京:金原出版;2020.p.69-70.
- 2) Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378-90.
- 3) Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009;10:25-34.
- 4) Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018;391:1163-73.
- 5) Bruix J, Qin S, Merle P, Granito A, et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;389:56-66.
残りの11件を表示する
- 6) Abou-Alfa GK, Meyer T, Cheng AL, et al. Cabozantinib in Patients with Advanced and Progressing Hepatocellular Carcinoma. N Engl J Med. 2018;379:54-63.
- 7) Zhu AX, Park JO, Ryoo BY, et al. Ramucirumab versus placebo as second-line treatment in patients with advanced hepatocellular carcinoma following first-line therapy with sorafenib (REACH): a randomised, double-blind, multicentre, phase 3 trial. Lancet Oncol. 2015;16:859-70.
- 8) Zhu AX, Kang YK, Yen CJ, et al. Ramucirumab after sorafenib in patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations (REACH-2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019;20:282-96.
- 9) Yau T, Park JW, Finn RS, et al. CheckMate 459: A randomized, multicenter phase III study of nivolumab (NIVO) vs sorafenib (SOR) as first-line (1L) treatment in patients (pts) with advanced hepatocellular carcinoma (aHCC). Ann Oncol. 2019;30 Supple 5:v874-5.
- 10) Finn RS, Ryoo BY, Merle P, et al. Pembrolizumab As Second-Line Therapy in Patients With Advanced Hepatocellular Carcinoma in KEYNOTE-240: A Randomized, Double-Blind, Phase III Trial. J Clin Oncol. 2020;38:193-202.
- 11) Finn RS, Qin S, Ikeda M, et al. Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma. N Engl J Med. 2020;382:1894-905.
- 12) Ogasawara S, Chiba T, Ooka Y, et al. Efficacy of sorafenib in intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization. Oncology. 2014;87:330-41.
- 13) Arizumi T, Ueshima K, Minami T, et al. Effectiveness of Sorafenib in Patients with Transcatheter Arterial Chemoembolization (TACE) Refractory and Intermediate-Stage Hepatocellular Carcinoma. Liver Cancer. 2015;4:253-62.
- 14) Ohki T, Sato K, Yamagami M, et al. Efficacy of transcatheter arterial chemoembolization followed by sorafenib for intermediate/advanced hepatocellular carcinoma in patients in Japan: a retrospective analysis. Clin Drug Investig. 2015;35:751-9.
- 15) Kudo M, Ueshima K, Chan S, et al. Lenvatinib as an Initial Treatment in Patients with Intermediate-Stage Hepatocellular Carcinoma Beyond Up-To-Seven Criteria and Child-Pugh A Liver Function: A Proof-Of-Concept Study. Cancers (Basel). 2019;11:1084.
- 16) Kudo M, Ueshima K, Ikeda M, et al. Randomised, multicentre prospective trial of transarterial chemoembolisation (TACE) plus sorafenib as compared with TACE alone in patients with hepatocellular carcinoma: TACTICS trial. Gut. 2020;69:1492-501.
