摘要
索拉非尼是一种小分子的细胞内酪氨酸和丝氨酸/苏氨酸蛋白激酶抑制剂(VEGFR, PDGFR, CRAF和 BRAF),被认为也能诱导自噬的发生和影响肿瘤生长的主要机制。索拉非尼针对非手术切除的肝癌(HCC)的管理是有效果的,而针对其他化疗药物,具有难治性。肝癌是慢性肝脏疾病的一个主要终点和癌症相关死亡的第三大原因。有索拉非尼的肝癌患者的总体生存率与安慰剂组相比增加了。在西方国家影响到30%的人口的最常见的慢性肝脏疾病是非酒精性脂肪性肝病(NAFLD),肝内积聚的甘油三酯被视为胰岛素抵抗和肥胖的肝脏表现。NAFLD包括一系列肝损伤程度不同的疾病,从脂肪肝到非酒精性脂肪肝炎(NASH),以纤维化存在与否的肝细胞损伤/炎症为标记。NAFLD患者进展到NASH在10%的情况下,可进展为肝硬化和肝细胞癌。最近激动人心的研究发现Sorafenib 超越肝癌的潜在的治疗作用,并延伸至肝硬化中门静脉高压综合征,并通过活化的肝星状细胞(HSC),直接抑制介导肝内基质沉积的细胞介质,选择性的产生抗肝纤维化作用。本文的目的是简要总结我国当前的生物学知识,流行病学和临床肝癌的方面,以及先前被低估的Sorafenib 超过肝癌的疗效。因此本文利用与肝脏疾病光谱相关的数据,包括通过实验的预临床到临床。
关键词: 索拉非尼;肝细胞癌;NASH; HBV;HCV;肝硬化。
图形摘要
Current Drug Targets
Title:Biology, Epidemiology, Clinical Aspects of Hepatocellular Carcinoma and the Role of Sorafenib
Volume: 17 Issue: 7
Author(s): Gianluigi Mazzoccoli, Luca Miele, Jude Oben, Antonio Grieco, Manlio Vinciguerra
Affiliation:
关键词: 索拉非尼;肝细胞癌;NASH; HBV;HCV;肝硬化。
摘要: Sorafenib is a small molecular inhibitor of intracellular tyrosine and serine/threonine protein kinases (VEGFR, PDGFR, CRAF and BRAF), and is thought also to induce autophagy, a chief mechanism influencing tumor growth. Sorafenib shows efficacy in the management of non-resectable hepatocellular carcinoma (HCC), which is refractory to other chemotherapeutic drugs. HCC represents a major end point of chronic liver diseases and the third leading cause of cancer-related death. In HCC patients Sorafenib increases overall survival compared to placebo. The most common chronic liver disease affecting up to 30% of the population in Western countries is non-alcoholic fatty liver disease (NAFLD), an intra-hepatic amassing of triglycerides deemed as the hepatic manifestation of insulin resistance and obesity. NAFLD encompasses a range of disorders with grades of liver damage varying from steatosis to non-alcoholic steatohepatitis (NASH), hallmarked by hepatocellular injury/inflammation in the presence or not of fibrosis. NAFLD patients progress to NASH in 10% of cases, which may progress to cirrhosis and HCC. Recent exciting studies uncovered a potential therapeutic role for Sorafenib that goes beyond HCC, and extends to cirrhotic portal hypertensive syndrome during cirrhosis, and to selective anti-fibrotic effects mediated through direct inhibition of activated hepatic stellate cells (HSC), the cellular mediators of intra-hepatic matrix deposition. The aim of this review is to concisely summarize our current knowledge of the biology, epidemiology and clinical aspects of HCC, as well as the previously under-appreciated therapeutic efficacy of Sorafenib beyond HCC. The review therefore utilizes data along the spectrum of liver diseases, including from experimental via pre-clinical to clinical.
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Cite this article as:
Gianluigi Mazzoccoli, Luca Miele, Jude Oben, Antonio Grieco, Manlio Vinciguerra , Biology, Epidemiology, Clinical Aspects of Hepatocellular Carcinoma and the Role of Sorafenib, Current Drug Targets 2016; 17 (7) . https://dx.doi.org/10.2174/1389450117666151209120831
DOI https://dx.doi.org/10.2174/1389450117666151209120831 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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