Clinical Drug Investigation

, Volume 32, Supplement 2, pp 37–51 | Cite as

Current Status of Hepatocellular Carcinoma Treatment in Japan

Case Study and Discussion-Voting System
  • Masatoshi KudoEmail author
  • Ryosuke Tateishi
  • Tatsuya Yamashita
  • Masafumi Ikeda
  • Junji Furuse
  • Kenji Ikeda
  • Norihiro Kokudo
  • Namiki Izumi
  • Osamu Matsui
Review Article


The Toward Integrated Treatment of Advanced Hepatocellular Carcinoma with Nexavar (TiTAN) Symposium was held in August 2010 in Tokyo, Japan, during which the position of sorafenib (Nexavar®) in the treatment of HCC in Japan (for which it received approval in 2009) was discussed by a panel of eight expert hepatologists in a session chaired by Dr Kudo. The following article focuses on the discussion that went on during this session, including question and answer sessions regarding the experiences of the 350 conference attendees in treating patients with HCC, as well as some of the more challenging disease management issues.

Since 2008, when the phase III Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) trial demonstrated an increase in the median overall survival (OS) for patients with unresectable HCC treated with sorafenib compared with placebo, international and Japanese guidelines recommend sorafenib as a first-line option for patients with advanced HCC Child-Pugh liver function class A who have extrahepatic metastasis. Sorafenib is also recommended for patients unresponsive to transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC). Importantly, if HCC is judged to be unresponsive to TACE, treatment should be switched to sorafenib in a timely manner.

Almost half of the conference attendees said that they used both the Japan Society of Hepatology clinical practice guidelines and the clinical practice guidelines for HCC when determining treatment strategies for individual HCC patients. Sorafenib should currently not be used as adjuvant therapy or in combination with TACE or HAIC until evidence from ongoing clinical trials shows that it is beneficial in these settings.


Sorafenib Tace Vascular Invasion Extrahepatic Metastasis Barcelona Clinic Liver Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Adis Data Information BV 2012

Authors and Affiliations

  • Masatoshi Kudo
    • 1
    Email author
  • Ryosuke Tateishi
    • 2
  • Tatsuya Yamashita
    • 3
  • Masafumi Ikeda
    • 4
  • Junji Furuse
    • 5
  • Kenji Ikeda
    • 6
  • Norihiro Kokudo
    • 7
  • Namiki Izumi
    • 8
  • Osamu Matsui
    • 9
  1. 1.Department of Gastroenterology and HepatologyKinki University School of MedicineOsaka-Sayama, OsakaJapan
  2. 2.Department of GastroenterologyUniversity of Tokyo HospitalTokyoJapan
  3. 3.Department of GastroenterologyKanazawa University HospitalKanazawaJapan
  4. 4.Division of Hepatobiliary and Pancreatic OncologyNational Cancer Center Hospital EastKashiwaJapan
  5. 5.Medical Oncology DivisionKyorin University School of MedicineMitakaJapan
  6. 6.Department of HepatologyToranomon HospitalTokyoJapan
  7. 7.Hepato-Biliary Pancreatic Surgery Division, Department of Surgery, Graduate School of MedicineUniversity of TokyoTokyoJapan
  8. 8.Department of Gastroenterology and HepatologyMusashino Red Cross HospitalMusashinoJapan
  9. 9.Department of Imaging Diagnosis and Interventional Radiology, Division of Cardiovascular MedicineKanazawa University Graduate School of Medical ScienceKanazawaJapan

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