Silk T, Silk M, Wu J. Up to seven criteria in selection of systemic therapy for hepatocellular carcinoma. World J Gastroenterol 2022; 28(23): 2561-2568 [PMID: 35949352 DOI: 10.3748/wjg.v28.i23.2561]
Corresponding Author of This Article
Jennifer Wu, MD, Associate Professor, Attending Doctor, Division of Hematology and Oncology, Perlmutter Cancer Center of NYU Langone Health, NYU School of Medicine, 462 First Ave, BCD556, New York, NY 10016, United States. jennifer.wu@nyulangone.org
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 21, 2022; 28(23): 2561-2568 Published online Jun 21, 2022. doi: 10.3748/wjg.v28.i23.2561
Up to seven criteria in selection of systemic therapy for hepatocellular carcinoma
Tarik Silk, Mikhail Silk, Jennifer Wu
Tarik Silk, Department of Internal Medicine, NYU Grossman School of Medicine, New York, NY 10016, United States
Mikhail Silk, Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
Jennifer Wu, Division of Hematology and Oncology, Perlmutter Cancer Center of NYU Langone Health, NYU School of Medicine, New York, NY 10016, United States
Author contributions: Silk T drafted the manuscript, coordinated all the author's efforts and provided the final revisions; Silk M edited the section related to interventional radiology and TACE; Wu J provided the concept of the manuscript, established the structure of the manuscript, offered the references and revised the drafts.
Conflict-of-interest statement: Dr. Silk has nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jennifer Wu, MD, Associate Professor, Attending Doctor, Division of Hematology and Oncology, Perlmutter Cancer Center of NYU Langone Health, NYU School of Medicine, 462 First Ave, BCD556, New York, NY 10016, United States. jennifer.wu@nyulangone.org
Received: December 29, 2021 Peer-review started: December 29, 2021 First decision: March 10, 2022 Revised: March 25, 2022 Accepted: April 30, 2022 Article in press: April 30, 2022 Published online: June 21, 2022
Abstract
Barcelona clinic liver cancer (BCLC) intermediate stage hepatocellular carcinoma is a heterogenous disease. Transarterial chemoembolization is offered as the first line therapy in this disease stage. Recent advances in systemic therapy have markedly improved outcomes even in advanced stage disease. The use of systemic therapy in BCLC intermediate stage disease may now be of therapeutic benefit in selected patients. We will focus on “the up to seven” criteria and its utility in selecting systemic therapy.
Core Tip: Barcelona clinic liver cancer intermediate stage disease that exceeds “the up to seven” criteria, especially with lesions larger than 5 cm, is less likely to respond to transarterial chemoembolization (TACE) alone and is therefore a disease that may respond better to systemic therapy. The use of “the up to seven” criteria can be a helpful guidepost for when to consider systemic therapy alone or in addition to TACE. With the recent breakthroughs in immunotherapy for advanced hepatocellular carcinoma which clearly demonstrated overall survival advantage over single agent tyrosine kinase inhibitors sorafenib, it is promising that the use of immunotherapy would likely lead to better outcome when used in intermediate disease.
