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Current Status of Hepatocellular Carcinoma Treatment in Japan

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Abstract

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.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Masatoshi Kudo

  2. Department of Gastroenterology, University of Tokyo Hospital, Tokyo, Japan

    Ryosuke Tateishi

  3. Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan

    Tatsuya Yamashita

  4. Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan

    Masafumi Ikeda

  5. Medical Oncology Division, Kyorin University School of Medicine, Mitaka, Japan

    Junji Furuse

  6. Department of Hepatology, Toranomon Hospital, Tokyo, Japan

    Kenji Ikeda

  7. Hepato-Biliary Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

  8. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino, Japan

    Namiki Izumi

  9. Department of Imaging Diagnosis and Interventional Radiology, Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

    Osamu Matsui

Authors
  1. Masatoshi Kudo
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  2. Ryosuke Tateishi
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  3. Tatsuya Yamashita
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  4. Masafumi Ikeda
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  5. Junji Furuse
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  6. Kenji Ikeda
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  7. Norihiro Kokudo
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  8. Namiki Izumi
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  9. Osamu Matsui
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Correspondence to Masatoshi Kudo.

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Kudo, M., Tateishi, R., Yamashita, T. et al. Current Status of Hepatocellular Carcinoma Treatment in Japan. Clin Drug Investig 32 (Suppl 2), 37–51 (2012). https://doi.org/10.1007/BF03265495

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