Indonesian consensus on systemic therapies for hepatocellular carcinoma
Corresponding Author
Irsan Hasan
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Correspondence
Irsan Hasan, Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia.
Email: [email protected]
Search for more papers by this authorImelda Maria Loho
Department of Gastroentero-Hepatology, “Dharmais” National Cancer Center Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorPoernomo Boedi Setiawan
Division of Gastroentero-Hepatology, Department of Internal Medicine, Soetomo General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Search for more papers by this authorAli Djumhana
Division of Gastroentero-Hepatology, Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjajaran, Bandung, Indonesia
Search for more papers by this authorHery Djagat Purnomo
Division of Gastroentero-Hepatology, Department of Internal Medicine, Kariadi General Hospital, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
Search for more papers by this authorLianda Siregar
Department of Gastroentero-Hepatology, “Dharmais” National Cancer Center Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorRino Alvani Gani
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorAndri Sanityoso Sulaiman
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorCosmas Rinaldi Adithya Lesmana
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorCorresponding Author
Irsan Hasan
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Correspondence
Irsan Hasan, Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Jakarta 10430, Indonesia.
Email: [email protected]
Search for more papers by this authorImelda Maria Loho
Department of Gastroentero-Hepatology, “Dharmais” National Cancer Center Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorPoernomo Boedi Setiawan
Division of Gastroentero-Hepatology, Department of Internal Medicine, Soetomo General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Search for more papers by this authorAli Djumhana
Division of Gastroentero-Hepatology, Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjajaran, Bandung, Indonesia
Search for more papers by this authorHery Djagat Purnomo
Division of Gastroentero-Hepatology, Department of Internal Medicine, Kariadi General Hospital, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
Search for more papers by this authorLianda Siregar
Department of Gastroentero-Hepatology, “Dharmais” National Cancer Center Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorRino Alvani Gani
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorAndri Sanityoso Sulaiman
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorCosmas Rinaldi Adithya Lesmana
Hepatobiliary Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Search for more papers by this authorAbstract
Hepatocellular carcinoma (HCC) is a deadly cancer with a rising incidence in the last 20 years. Most patients are diagnosed late when curative treatment is no longer feasible. With the background of chronic liver disease in most patients, the management of HCC becomes more complicated, in which well-preserved liver function is a prerequisite for locoregional or systemic therapies. In 2008, sorafenib became the first systemic agent proven to provide survival benefit for patients with advanced-stage HCC. For nearly a decade, no treatment has succeeded in providing better results than sorafenib. However, numerous advances in systemic therapies have emerged in the last 5 years to fulfill the unmet needs of effective therapeutic options. Several agents have been approved for clinical use after positive results in phase III clinical trials, including lenvatinib, regorafenib, cabozantinib, ramucirumab, and lastly immune checkpoint inhibitor atezolizumab in combination with bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor. With various options available, knowledge on the clinical evidence of each drug, their safety profile, as well as the patient characteristics and preferences become mandatory in clinical decision making. The objective of this consensus is to help clinicians, health-care workers, and policy makers in providing best clinical care for HCC patients.
CONFLICT OF INTEREST
The authors have no conflict of interest to declare.
Open Research
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no new data were created or analyzed in this study.
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