Systemic Therapy for Advanced Hepatocellular Carcinoma: ASCO Guideline

作者：John D. Gordan, Erin B. Kennedy, Ghassan K. Abou‐Alfa, Muhammad Shaalan Beg, Steven T. Brower, T. Gade, Laura W. Goff, Shilpi Gupta, Jennifer Guy, William Proctor Harris, Renuka Iyer, Ishmael Jaiyesimi, Minaxi Jhawer, Asha Karippot, Ahmed O. Kaseb, Robin Kate Kelley, Jennifer J. Knox, Jeremy Kortmansky, Andrea Leaf, William Remak, Rachna T. Shroff, Davendra Sohal, Tamar H. Taddei, Neeta K. Venepalli, Andrea Wilson, Andrew X. Zhu, Michal G. Rose · 发表于：Journal of Clinical Oncology · 年份：2020 · DOI：10.1200/jco.20.02672 · 被引用次数：618 · 研究领域：Pancreatic and Hepatic Oncology Research、Hepatocellular Carcinoma Treatment and Prognosis、Colorectal Cancer Treatments and Studies

PURPOSE: To develop an evidence-based clinical practice guideline to assist in clinical decision making for patients with advanced hepatocellular carcinoma (HCC). METHODS: ASCO convened an Expert Panel to conduct a systematic review of published phase III randomized controlled trials (2007-2020) on systemic therapy for advanced HCC and provide recommended care options for this patient population. RESULTS: Nine phase III randomized controlled trials met the inclusion criteria. RECOMMENDATIONS: Atezolizumab + bevacizumab (atezo + bev) may be offered as first-line treatment of most patients with advanced HCC, Child-Pugh class A liver disease, Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1, and following management of esophageal varices, when present, according to institutional guidelines. Where there are contraindications to atezolizumab and/or bevacizumab, tyrosine kinase inhibitors sorafenib or lenvatinib may be offered as first-line treatment of patients with advanced HCC, Child-Pugh class A liver disease, and ECOG PS 0-1. Following first-line treatment with atezo + bev, and until better data are available, second-line therapy with a tyrosine kinase inhibitor may be recommended for appropriate candidates. Following first-line therapy with sorafenib or lenvatinib, second-line therapy options for appropriate candidates include cabozantinib, regorafenib for patients who previously tolerated sorafenib, or ramucirumab (for patients with α-fetoprotein ≥ 400 ng/...