Resistance to Molecular Therapies for Hepatocellular Carcinoma

This volume evaluates the clinical patterns of resistance to sorafenib, the impact of trial design in the second-line setting and the current gold-standard to define radiological resistance; describes the molecular mechanisms responsible for treatment resistance in HCC patients, including components of the immune system and tumor microenvironment; determines the role of the cancer stem cell phenotype in resistance; reviews the experimental models to study resistance; and addresses new approaches to overcome resistance to sorafenib, using successful examples from other malignancies.

Liver cancer is the second cause of cancer-related death worldwide, with a mortality rate, which in the United States (U.S.) has increased more than 50% in the last 20 years. As highlighted by the National Cancer Institute in their 2016 report, the steady increase in liver cancer deaths is a cause for concern. It remains as one of the deadliest malignancies with a high ratio of mortality to incidence (i.e., 0.95). In the U.S., recent data estimate that in 2014 there were 33,190 new cases of liver cancer. Overall, patient’s 5-year survival is 16%, second worst only behind pancreatic cancer. The molecular agent sorafenib was the first systemic agent to increase survival in HCC patients. In 2016, another tyrosine kinase inhibitor (i.e., regorafenib) was able to increase survival in patients who progressed or were intolerant to sorafenib. Unlike other solid tumors, there are no robust predictive biomarkers of response to any of these therapies. Clinical trials in other scenarios such as combination with loco-regional treatments or adjuvancy after resection or ablation also failed to provide meaningful survival benefits. Altogether, these data underscore the need for new approaches to treat liver cancer, including a better understanding of the mechanisms that drive cancer resistance. 

• ISBN: 978-3-319-56196-7
• Editorial: Springer
• Encuadernacion: Cartoné
• Páginas: 270
• Fecha Publicación: 17/08/2017
• Nº Volúmenes: 1
• Idioma: Inglés