Therapeutic targeting of VEGFR2 in HBV-associated hepatocellular carcinoma
Mené sur 400 patients atteints d'un carcinome hépatocellulaire de stade avancé, cet essai de phase III évalue l'efficacité, du point de vue de la survie globale, et la toxicité de l'apatinib en traitement de deuxième ligne ou au-delà, après l'échec d'une ou plusieurs lignes de chimiothérapie ou de thérapie ciblée
Hepatitis B virus (HBV) infection is the leading global cause of hepatocellular carcinoma,with over 350 million people being identified as chronic HBV carriers. Insertionalmutagenesis from HBV DNA integration into the host genome promotes genomic instabilityand synergises with cell cycle dysregulation at an epigenetic and post-translationallevel, leading to hepatocyte transformation. In the context of HBV infection, hepatocellular carcinoma can occur at a young ageand in the absence of cirrhosis, with the prognostic outlook being fundamentally linkedto the quality and duration of HBV DNA suppression. Integrative molecular and pathological classification studies now converge in definingHBV-associated hepatocellular carcinoma as a subset of poorly differentiated, highlyproliferating tumours, often accompanied by higher circulating
α-fetoprotein concentrations. These features highlight a subset of patients with hepatocellular carcinoma characterisedby poor prognosis and a particularly unmet need for therapy options.
The Lancet Gastroenterology & Hepatology , commentaire, 2020