| Theme |
Treatment Strategy for Advanced Hepatocellular Carcinoma |
| Title |
Initiation and Discontinuation of Molecular—targeted Drug Therapy for Advanced Hepatocellular Carcinoma |
| Author |
Tatsuya Yamashita |
Department of Gastroenterology, Kanazawa University Hospital |
| Author |
Takeshi Terashima |
Department of Gastroenterology, Kanazawa University Hospital |
| Author |
Kuniaki Araki |
Department of Gastroenterology, Kanazawa University Hospital |
| Author |
Shuichi Kaneko |
Department of Gastroenterology, Kanazawa University Hospital |
| [ Summary ] |
Sorafenib is currently the only molecular‒targeted drug for advanced hepatocellular carcinoma. Sorafenib administration is considered in case of persevered hepatic reserve, in the case of Child‒Pugh class A hepatic reserve with macrovascular invasion of hepatocellular carcinoma, or extrahepatic metastasis. In case of intrahepatic metastasis, the inefficacy of trancecatheter arterial chemoembolization (TACE) is judged according to the JSH‒LCSGJ criteria for the failure/refractoriness of TACE. The discontinuation of sorafenib therapy depends on the radiological progression as well as the aggravation of symptoms. Moreover, the progression pattern, degree of adverse events, cost effectiveness, and quality of life should be considered when contemplating discontinuation. |