Villarruel-Melquiades F, Mendoza-Garrido ME, García-Cuellar CM, Sánchez-Pérez Y, Pérez-Carreón JI, Camacho J. Current and novel approaches in the pharmacological treatment of hepatocellular carcinoma. World J Gastroenterol 2023; 29(17): 2571-2599 [PMID: 37213397 DOI: 10.3748/wjg.v29.i17.2571]
Corresponding Author of This Article
Javier Camacho, BSc, MSc, PhD, Research Scientist, Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Avenida Instituto Politécnico Nacional 2508, Mexico City 07360, Mexico. fcamacho@cinvestav.mx
Research Domain of This Article
Oncology
Article-Type of This Article
Review
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. May 7, 2023; 29(17): 2571-2599 Published online May 7, 2023. doi: 10.3748/wjg.v29.i17.2571
Current and novel approaches in the pharmacological treatment of hepatocellular carcinoma
Fernanda Villarruel-Melquiades, María Eugenia Mendoza-Garrido, Claudia M García-Cuellar, Yesennia Sánchez-Pérez, Julio Isael Pérez-Carreón, Javier Camacho
Fernanda Villarruel-Melquiades, Javier Camacho, Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Mexico City 07360, Mexico
María Eugenia Mendoza-Garrido, Departamento de Fisiología, Biofísica y Neurociencias, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Mexico City 07360, Mexico
Claudia M García-Cuellar, Yesennia Sánchez-Pérez, Subdirección de Investigación Básica, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
Julio Isael Pérez-Carreón, Instituto Nacional de Medicina Genómica, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City 14610, Mexico
Author contributions: Villarruel-Melquiades F and Camacho J wrote the paper and made substantial contributions to conception of the manuscript; Mendoza-Garrido ME, García-Cuellar CM, Sánchez-Pérez Y and Pérez-Carreón JI made critical revisions related to important intellectual content of the manuscript; all authors read and approved the final version of the article to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Javier Camacho, BSc, MSc, PhD, Research Scientist, Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Avenida Instituto Politécnico Nacional 2508, Mexico City 07360, Mexico. fcamacho@cinvestav.mx
Received: December 27, 2022 Peer-review started: December 27, 2022 First decision: January 11, 2023 Revised: January 19, 2023 Accepted: April 11, 2023 Article in press: April 11, 2023 Published online: May 7, 2023 Processing time: 130 Days and 11.7 Hours
Abstract
Hepatocellular carcinoma (HCC) is one of the most lethal malignant tumours worldwide. The mortality-to-incidence ratio is up to 91.6% in many countries, representing the third leading cause of cancer-related deaths. Systemic drugs, including the multikinase inhibitors sorafenib and lenvatinib, are first-line drugs used in HCC treatment. Unfortunately, these therapies are ineffective in most cases due to late diagnosis and the development of tumour resistance. Thus, novel pharmacological alternatives are urgently needed. For instance, immune checkpoint inhibitors have provided new approaches targeting cells of the immune system. Furthermore, monoclonal antibodies against programmed cell death-1 have shown benefits in HCC patients. In addition, drug combinations, including first-line treatment and immunotherapy, as well as drug repurposing, are promising novel therapeutic alternatives. Here, we review the current and novel pharmacological approaches to fight HCC. Preclinical studies, as well as approved and ongoing clinical trials for liver cancer treatment, are discussed. The pharmacological opportunities analysed here should lead to significant improvement in HCC therapy.
Core Tip: Hepatocellular carcinoma (HCC) is one of the most lethal malignant tumours worldwide. Unfortunately, most HCC cases are diagnosed at an advanced stage, and "curative" options are not suggested for these patients. The best option is to start with drug therapy, with sorafenib and lenvatinib as the first-choice drugs. However, most patients do not respond to these treatments; therefore, new therapeutic strategies are urgently needed. Here, we review current potential and novel pharmacological approaches, including immunotherapy, drug combination, and drug repositioning, that should help to improve the prognosis of HCC patients.
