Angiogenesis in Hepatocellular Carcinoma; Pathophysiology, Targeted Therapy, and Role of Imaging
| Autor: | Scott A Rohren, Ahmed Kaseb, Khaled M Elsayes, Amita Kamath, Katherine J. Blair, Chandana Lall, Ahmed W Moawad, Janio Szklaruk |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Sorafenib medicine.medical_specialty Cirrhosis business.industry Angiogenesis medicine.medical_treatment Radiogenomics medicine.disease Targeted therapy Vascular endothelial growth factor chemistry.chemical_compound chemistry Internal medicine Hepatocellular carcinoma Medicine business Lenvatinib medicine.drug |
| Zdroj: | Journal of Hepatocellular Carcinoma. 7:77-89 |
| ISSN: | 2253-5969 |
| DOI: | 10.2147/jhc.s224471 |
| Popis: | Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide, usually occurring on a background of liver cirrhosis. HCC is a highly vascular tumor in which angiogenesis plays a major role in tumor growth and spread. Tumor-induced angiogenesis is usually related to a complex interplay between multiple factors and pathways, with vascular endothelial growth factor being a major player in angiogenesis. In the past decade, understanding of tumor-induced angiogenesis has led to the emergence of novel anti-angiogenic therapies, which act by reducing neo-angiogenesis, and improving patient survival. Currently, Sorafenib and Lenvatinib are being used as the first-line treatment for advanced unresectable HCC. However, a disadvantage of these agents is the presence of numerous side effects. A major challenge in the management of HCC patients being treated with anti-angiogenic therapy is effective monitoring of treatment response, which decides whether to continue treatment or to seek second-line treatment. Several criteria can be used to assess response to treatment, such as quantitative perfusion on cross-sectional imaging and novel/emerging MRI techniques, including a host of known and emerging biomarkers and radiogenomics. This review addresses the pathophysiology of angiogenesis in HCC, accurate imaging assessment of angiogenesis, monitoring effects of anti-angiogenic therapy to guide future treatment and assessing prognosis. |
| Databáze: | OpenAIRE |
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