Antiangiogenic agents after first line and sorafenib plus chemoembolization: a systematic review

Andrea Casadei Gardini _, Daniele Santini, Giuseppe Aprile, Nicola Silvestris, Emanuele Felli, Francesco Giuseppe Foschi, Giorgio Ercolani, Giorgia Marisi, Martina Valgiusti, Alessandro Passardi, Marco Puzzoni, Marianna Silletta, Oronzo Brunetti, Giovanni Gerardo Cardellino, Giovanni Luca Frassineti and Mario Scartozzi

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Oncotarget. 2017; 8:66699-66708. https://doi.org/10.18632/oncotarget.19449

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Andrea Casadei Gardini1, Daniele Santini2, Giuseppe Aprile3, Nicola Silvestris4, Emanuele Felli5, Francesco Giuseppe Foschi6, Giorgio Ercolani7,8, Giorgia Marisi9, Martina Valgiusti1, Alessandro Passardi1, Marco Puzzoni10, Marianna Silletta2, Oronzo Brunetti4, Giovanni Gerardo Cardellino3, Giovanni Luca Frassineti1 and Mario Scartozzi10

1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e Cura dei Tumori (IRST) IRCCS, Meldola, Italy

2Medical Oncology Department, University Campus Bio-Medico, Via Álvaro del Portillo, Rome, Italy

3Department of Medical Oncology, University Hospital, Udine, Italy

4Medical Oncology Unit, National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy

5Hôpital Hautepierre Service de Chirurgie Générale, Hépatique, Endocrinienne et Transplantation Université de Strasbourg, Strasbourg, France

6DPT Internal Medicine, Faenza Hospital, Faenza, AUSL Romagna, Forli, Italy

7Department of General Surgery, Morgagni-Pierantoni Hospiatal, AUSL Romagna, Forli, Italy

8Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

9Biosciences Laboratory, IRST IRCCS, Meldola, Italy

10Department of Medical Oncology, University Hospital Cagliari, Cagliari, Italy

Correspondence to:

Andrea Casadei Gardini, email: [email protected]

Keywords: hepatocellular carcinoma, tace, antiangiogenic, second line, transcatheter arterial chemoembolization

Received: November 22, 2016    Accepted: April 27, 2017    Published: July 22, 2017


Transarterial chemoembolization (TACE) is the standard treatment for intermediate stage, although the combination of TACE with sorafenib may theoretically benefit HCC patients in intermediate stage. Owing to the significant antiangiogenic effect of sorafenib and the limitation of TACE, it is rational to combine them. Though the strategy of combining TACE and sorafenib has been increasingly used in patients with unresectable HCC but the current evidence is controversial and its clinical role has not been determined yet.

In first-line therapy, patients receiving sorafenib had increased overall survival and progression free survival. Therefore several antiangiogenic agents have entered clinical studies on HCC, many with negative results. This review discusses the current drug development for patients with HCC and role of TACE plus sorafenib.

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