The impact of molecular targeted therapies and the multidisciplinary management for survival of patients with advanced hepatocellular carcinoma

We reviewed the clinical outcomes of advanced hepatocellular carcinoma (HCC) patients were treated with medical treatments such as hepatic arterial infusion chemotherapy (HAIC) (n=562), sorafenib (n=320), Lenvatinib (Len) (n=230), Regorafenib (n=55), Ramcirumab (n=26) and Atezolizumab + Bevacizumab (n=52) at our hospital and affiliated hospitals from 2000 to 2020. Median Survival Time (MST) was significantly longer according to the era (9.4, 11.4 and 18.8 months).
As for Len, positive immunohistochemistry for FGFR4 in biopsy samples before Len was associated with a favorable objective response rate (81%). (Clin Transl Gastroenterol. 2020). Furthermore, the progression free survival and survival rate of the LEN-Trans arterial chemoembolization (TACE) sequential therapy group was significantly higher than that of the LEN-alone group. (Oncology. 2021). On the other hand, MST of the patients in the group of the patients with macroscopic vascular invasion (MVI) were no difference in each era. We recently reported that in HAIC and RT for Vp4, MST were 12.1 months (Liver cancer. 2020). Although, MST of advanced HCC patients was longer according to the era, there was no difference about OS for the group of the patients with MVI in each era. In future, we hope Atezolizumab + Bevacizumab could provide the survival benefit for the high risk group such as REFLECT out.