Targeted drugs for the treatment of liver cancer

Liver cancer is mainly caused by HBV, with middle-aged men being the primary affected group. The stage of liver cancer is divided into early, middle, and late stages, each requiring a different treatment approach. If the tumor exists only in the liver, is less than 5 cm in size, and the number of lesions does not exceed three, it is considered early-stage liver cancer. For these patients, local treatments including surgery, radiotherapy, ablation, and freezing can effectively resolve the problem without the need for targeted therapy. If the liver tumor has grown relatively large or involves multiple lesions but has not yet invaded blood vessels or spread to other parts of the body, the tumor has reached the middle stage, and patients can still achieve long-term survival through surgery, interventional therapy, and radiotherapy.

However, if the tumor has further developed, has already invaded blood vessels, or has metastasized to other parts of the body, it is considered advanced-stage liver cancer. At this point, patients often have only a few months to survive without aggressive intervention, and targeted therapy becomes an indispensable treatment method to control the spread of cancer cells and extend survival.

At present, the only globally recognized targeted drugs for the treatment of advanced liver cancer are sorafenib (Nexavar) and regorafenib (Stivarga). Among these, regorafenib has not been approved for liver cancer indications in China, making sorafenib the only standard targeted treatment for advanced liver cancer available in the country. Between 2007 and 2017, numerous clinical trials of other targeted drugs were conducted for liver cancer, including sunitinib, brivanib, linifanib, dovitinib, and nintedanib — nearly all of which failed to produce meaningful results.

Only a few drugs have achieved unexpected positive outcomes in the treatment of liver cancer. Lenvatinib (also referred to as 7080 in China), originally developed for thyroid cancer, has demonstrated efficacy in liver cancer treatment as well. Cabozantinib (known as 184 among some domestic patients), another vasostatic agent similar to lenvatinib, has shown that it can shrink tumors in 5% of liver cancer patients and stabilize disease in 66% of patients, meaning tumors stopped growing. Large-scale clinical research on cabozantinib for liver cancer is currently underway, and its results are worth looking forward to. Patients must note, however, that most advanced liver cancer drugs have not yet been approved by the State Drug Administration, and foreign imported drugs carry the disadvantages of high costs and variable efficacy. Treatment decisions should always be made in consultation with physicians at qualified, professional medical institutions.