Primary Hepatic Carcinoma Medication

Updated: Feb 21, 2018
  • Author: Keith E Stuart, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Medication

Medication Summary

Systemic chemotherapy remains the mainstay of therapy for patients with advanced hepatocellular carcinoma who are not candidates for surgical resection, liver transplantation, or localized tumor ablation. Unfortunately, hepatocellular carcinoma is a relatively chemotherapy-resistant tumor. Antiangiogenic and immunotherapy agents have yielded promising results.

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Antineoplastic agents

Class Summary

Few options are available for the systemic therapy of hepatocellular carcinoma (see Treatment).

Sorafenib (Nexavar)

First oral multikinase inhibitor that targets serine/threonine and tyrosine receptor kinases in both the tumor cell and the tumor vasculature. Targets kinases involved in tumor cell proliferation and angiogenesis, thereby decreasing tumor cell proliferation. These kinases included RAF kinase, VEGFR-2, VEGFR-3, PDGFR-beta, KIT, and FLT-3. Indicated for unresectable hepatocellular carcinoma.

Sunitinib (Sutent)

Mulitkinase inhibitor that targets several tyrosine kinase inhibitors implicated in tumor growth, pathologic angiogenesis, and metastatic progression. Inhibits platelet-derived growth factor receptors (ie, PDGFR-alpha, PDGFR-beta), vascular endothelial growth factor receptors (ie, VEGFR1, VEGFR2, VEGFR3), stem cell factor receptor (KIT), Fms-like tyrosine kinase-3 (FLT3), colony-stimulating factor receptor type 1 (CSF-1R), and the glial cell-line–derived neurotrophic factor receptor (RET).

Erlotinib (Tarceva)

Pharmacologically classified as a human epidermal growth factor receptor type 1/epidermal growth factor receptor (HER1/EGFR) tyrosine kinase inhibitor. EGFR is expressed on the cell surface of normal cells and cancer cells.

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Immunosuppressant agents

Class Summary

Agents that inhibit signal transduction pathways may be of benefit.

Sirolimus (Rapamune)

Interferes with signal transduction pathways.

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Antineoplastics, Monoclonal Antibody

Nivolumab (Opdivo)

Monoclonal antibody to programmed cell death-1 protein (PD-1); blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2

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