Current and future management strategies for relapsed or progressive hepatoblastoma

被引:18
作者
Rajkumar Venkatramani
Wayne L. Furman
Joerg Fuchs
Steven W. Warmann
Marcio H. Malogolowkin
机构
[1] Division of HematologyOncology, Childrens Hospital Los Angeles, Los Angeles, CA
[2] Department of HematologyOncology, St Jude Childrens Research Hospital, Memphis, TN
[3] Department of Pediatric Surgery and Pediatric Urology, University of Tbingen, Tbingen
[4] Division of HematologyOncologyBone Marrow Transplant, Childrens Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI
关键词
1-Phosphatidylinositol-3-kinase-inhibitors; Angiogenesis-inhibitors; Antineoplastics; Beta-Catenin-inhibitors; Bevacizumab; Carboplatin; Children; Cisplatin; Cyclophosphamide; Doxorubicin; Doxorubicin-liposomal; Epidermal-growth-factor-receptor-antagonists; Etoposide; Fluorouracil; fms-like-tyrosine-kinase-3-inhibitors; Gene-therapies; Hedgehog-cell-signalling-; pathway-inhibitors; Ifosfamide; Immunotherapies; Irinotecan; Liver cancer; Liver-transplant; mTOR-protein-inhibitors; Oxaliplatin; Pazopanib; Platelet-derived-growth-factor-receptor-antagonists; Poly(ADP-ribose)-polymerase- inhibitors; Proto-oncogene-protein-c-akt-inhibitors; Proto-oncogene-protein-c-kit inhibitors; Proto-oncogene-protein-c-met-inhibitors; Proto-oncogene-protein-c-ret-; inhibitors; Raf-kinase-inhibitors; Somatomedin inhibitors; Sorafenib; Sunitinib; Surgery; Vincristine; Wnt-signalling-pathway-inhibitors;
D O I
10.2165/11597740-000000000-00000
中图分类号
学科分类号
摘要
Hepatoblastoma is the most common primary malignant neoplasm of the liver in children. Improvements in chemotherapy and surgical techniques have increased survival rates for those with localized disease. The prognosis for patients with progressive or relapsed disease continues to be dismal. Complete resection by surgery or liver transplantation is necessary for cure. Few conventional chemotherapy agents have demonstrated activity in progressive or relapsed hepatoblastoma. Irinotecan has shown activity in relapsed and progressive hepatoblastoma. The efficacy of high-dose chemotherapy in this setting is unknown. Newer targeted agents that 'selectively' interfere with pathway targets involved in tumor growth and progression such as insulin-like growth factor, phosphatidylinositol 3-kinase (PI3K), Akt, and mammalian target of rapamycin (mTOR) are currently under development. Because of the rarity of hepatoblastoma, only a small minority of these agents will ever be evaluated in children with this disorder. Gene-directed therapy and immunotherapy have shown promising results in the preclinical setting, and should be investigated as future treatment options for advanced hepatoblastoma. © 2012 Springer International Publishing AG. All rights reserved.
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页码:221 / 232
页数:11
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