演題抄録

FACO Symposium

開催概要
開催回
第53回・2015年・京都
 

Advancement of Clinical Trial on Liver Cancer in Japan

演題番号 : FS2-5

[筆頭演者]
Morizane Chigusa:1 
[共同演者]
Okusaka Takuji:1、Ikeda Masafumi:2

1:Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital、2:Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East

 

Sorafenib remains the only effective systemic treatment available for advanced-stage hepatocellular carcinoma (HCC) since the SHARP trial (2008) demonstrated a clear survival benefit. However, sorafenib failed to demonstrate significant benefits in early-stage and intermediate-stage HCC. Future challenges in treating advanced-stage HCC will include the development of first-line chemotherapies surpassing sorafenib and the development of effective second-line chemotherapies. Several phase III trials are underway: lenvatinib in a first-line setting, ramucirumab in patients with elevated baseline alpha-fetoprotein levels, and tivantinib in a c-MET high population in a second-line setting. With regard to immune checkpoint inhibitors, which have demonstrated promising anti-tumor activity against HCCs, several clinical trials including nivolumab are currently in progress or being planned. Additionally, since hepatic-arterial infusion therapies (HAI) have a practical place in the management of HCC in Japan, clinical trials of HAI such as addition to sorafenib are also of interest.
Gemcitabine + cisplatin combination therapy (GC) is a standard regimen for advanced biliary tract cancer, including intrahepatic cholangiocarcinoma (ICC). Currently, two randomized controlled trials comparing gemcitabine + S-1 vs. GC and gemcitabine + S-1 + cisplatin vs. GC are underway.
The nationwide cancer genome screening project for hepatobiliary and pancreatic cancer in Japan is currently being planned. Recently, a comprehensive genomic analysis identified genetic alterations such as a TERT promoter mutation and an alteration in the PI3K/mTOR pathway in patients with HCC. A FGFR2 fusion gene and IDH1 mutation was found in patients with ICC. Approaches to identify driver mutations in cancer patients will enable more efficient drug development and Precision Medicine.

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