Роль таргетной терапии в лечении распространенного гепатоцеллюлярного рака

Шахнович Е.Б., Кербиков О.Б., Кулага Е.А. Роль таргетной терапии в лечении распространенного гепатоцеллюлярного рака. Современная онкология. 2015; 1: 50–54.

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Shakhnovich E.B., Kerbikov O.B., Kulaga E.A. The role of targeted therapy in the treatment of advanced hepatocellular carcinoma. Journal of modern oncology. 2015; 1: 50–54.

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Аннотация

Гепатоцеллюлярный рак (ГЦР) является одним из наиболее распространенных онкологических заболеваний в мире. Успех терапии ГЦР напрямую зависит от диагностики заболевания на ранней стадии и своевременного назначения правильного лечения пациентам. Согласно современным рекомендациям системная стандартная лекарственная химиотерапия не является оптимальным вариантом лечения пациентов с распространенным ГЦР. В настоящее время единственным одобренным таргетным препаратом для лечения ГЦР является Нексавар (сорафениб). Сорафениб – первый таргетный препарат с доказанной способностью увеличивать общую выживаемость по сравнению с плацебо у пациентов с нерезектабельным ГЦР. На данный момент уже накоплен большой опыт применения сорафениба при ГЦР как в рамках международных клинических исследований (SHARP, Азиатско-Тихоокеанское исследование, GIDEON), так и в реальной практике в России.

Ключевые слова: гепатоцеллюлярный рак, первичный рак печени, таргетная терапия, сорафениб, Нексавар, химиотерапия, доксорубицин.

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Hepatocellular carcinoma (HCC) is the most common cancer in the world. The success of HCC therapy directly depends on diagnosis of early stage of the disease and proper treatment in a timely manner. According to the current recommendations, the systemic standard chemotherapy is not the best option for treating patients with advanced HCC. Nexavar (sorafenib) is currently the only approved targeted drug for the HCC treatment. Sorafenib is the first targeted drug with proven ability to improve overall survival in patients with HCC, compared with placebo. Researchers have already gained extensive experience in treatment HCC using sorafenib within the context of international clinical trials (SHARP, Asia-Pacific, GIDEON), and in actual clinical practice in Russia.

Key words: hepatocellular carcinoma, primary liver cancer, targeted therapy, sorafenib, Nexavar, chemotherapy, doxorubicin.

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Список литературы

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11. Llovet JM et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359 (4): 378–90.
12. Marrero J et al. Final analysis of GIDEON (Global Investigation of the rapeutic DEcisions in hepatocellular carcinoma and of its treatment with sorafeNib) in >3000 sorafenib-treated patients: clinical findings in patients with liver dysfunction. Poster presented at the Annual Meeting of the American Society of Clinical Oncology. May 31 – June 4 2013. Chicago, Illinois USA.
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14. Johnson PJ, Qin S, Park JW et al. Brivanib vs. sorafenib as first-line therapy in patients with unresectable, advanced hepatocellular carcinoma: results from the randomized phase III BRISK-FL study. J Clin Oncol 2013; 31 (28): 3517–24.
15. Boige V, Malka D, Bourredjem A et al. Efficacy, safety, and biomarkers of single-agent bevacizumab therapy in patients with advanced hepatocellular carcinoma. Oncologist 2012; 17 (8): 1063–72.
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1. Sangiovanni A, Prati GM, Fasani P et al. The natural history of compensated cirrhosis due to hepatitis C virus a 17-year cohort study of 214 patients. Hepatology 2006; 43: 1303–10.
2. EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol 2012; 56: 908–43.
3. Bruix J, Sherman M. Management of Hepatocellular Carcinoma: An Update. Hepatology 2011; 53 (3).
4. Verslype C, Rosmorduc O, Rougier P. ESMO Guidelines Working Group. Hepatocellular carcinoma: ESMO–ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012; 23 (Suppl. 7): vii41–8.
5. http://nccn.org
6. Prakticheskie rekomendatsii po lekarstvennomu lecheniiu bol'nykh pervichnym rakom pecheni Rossiiskogo obshchestva klinicheskoi onkologii (RUSSCO). Versiia 2014; s. 243–52. [in Russian]
7. Wilhelm S, Carter C, Lynch M et al. Discovery and development of sorafenib: a multikinase inhibitor for treating cancer. Nat Rev Drug Dis 2006; 5 (10): 835–44.
8. Abou-Alfa GK, Schwartz L, Ricci S et al. Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J Clin Oncol 2006; 24 (26): 4293–300.
9. Abou-Alfa GK, Johanson P, Knox J et al. Preliminary results from Phase II, randomized, double-blind study of sorafenib plus doxorubicin vs. placebo plus doxorubicin in patients with advanced hepatocellular carcinoma. ECCO 14 – European Cancer Conference. Barselona, Spain, 23–27 Sept. 2007.
10. 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 (1): 25–34.
11. Llovet JM et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359 (4): 378–90.
12. Marrero J et al. Final analysis of GIDEON (Global Investigation of the rapeutic DEcisions in hepatocellular carcinoma and of its treatment with sorafeNib) in >3000 sorafenib-treated patients: clinical findings in patients with liver dysfunction. Poster presented at the Annual Meeting of the American Society of Clinical Oncology. May 31 –June 4 2013. Chicago, Illinois USA.
13. Faivre S, Raymond E, Boucher E et al. Safety and efficacy of sunitinib in patients with advanced hepatocellular carcinoma: an open-label, multicentre, phase II study. Lancet Oncol 2009; 10 (8): 794–800.
14. Johnson PJ, Qin S, Park JW et al. Brivanib vs. sorafenib as first-line therapy in patients with unresectable, advanced hepatocellular carcinoma: results from the randomized phase III BRISK-FL study. J Clin Oncol 2013; 31 (28): 3517–24.
15. Boige V, Malka D, Bourredjem A et al. Efficacy, safety, and biomarkers of single-agent bevacizumab therapy in patients with advanced hepatocellular carcinoma. Oncologist 2012; 17 (8): 1063–72.
16. Zhu AX, Kudo M, Assenat E et al. EVOLVE-1: Phase 3 study of everolimus for advanced HCC that progressed during or after sorafenib. Abstr. J Clin Oncol 2014; 32 (Suppl. 3): 172.

Авторы

Е.Б.Шахнович*1, О.Б.Кербиков2, Е.А.Кулага3

1 ФГБУ Институт хирургии им. А.В.Вишневского Минздрава России. 117997, Россия, Москва, ул. Большая Серпуховская, д. 27;
2 ФГБУ Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России. 115682, Россия, Москва, Ореховый бульвар, д. 28;
3 ФГБОУ ВПО Московский государственный университет им. М.В.Ломоносова. 119192, Россия, Москва, Ломоносовский пр., д. 31, корп. 5
*shakhnovich@yandex.ru

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E.B.Shakhnovich*1, O.B.Kerbikov2, E.A.Kulaga3

1 A.V.Vishnevsky Institute of Surgery of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Bol'shaia Serpukhovskaia, d. 27;
2 Federal Research Center for Specialized Types of Medical Assistance and Medical Technologies of FMBA of Russia. 115682, Russian Federation, Moscow, Orekhovyi bul'var, d. 28;
3 M.V.Lomonosov Moscow State University. 119192, Russian Federation, Moscow, Lomonosovskii pr., d. 31, korp. 5
*shakhnovich@yandex.ru

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