From: Emerging treatment modalities for systemic therapy in hepatocellular carcinoma
Agent | Mechanism | FDA-approved indications |
---|---|---|
First-line | ||
 Sorafenib | Targeting VEGFR, PDGFR, c-KIT, RET, and Ras/Raf/MEK/ERK | As monotherapy in patients with unresectable or metastasis HCC |
 Lenvatinib | Targeting VEGFR, PDGFR, FGFR, RET, and SCFR | As monotherapy in patients with unresectable HCC |
 Atezolizumab + Bevacizumab | Anti-PD-L1 antibody + Anti-VEGF antibody | For patients with unresectable or metastatic HCC who have not received prior systemic therapy |
Second-line | ||
 Regorafenib | Targeting VEGFR, PDGFR, BRAF, FGFR, KIT, and RET | As monotherapy in sorafenib-experienced patients |
 Cabozantinib | Targeting VEGFR2, c-MET, AXL, KIT, and RET | As monotherapy in sorafenib-experienced patients |
 Ramucirumab | Anti-VEGFR antibody | As monotherapy in sorafenib-experienced patients with AFP of 400 ng/ml or higher |
 Nivolumab | Anti-PD-1 antibody | As monotherapy in sorafenib-experienced patients |
 Pembrolizumab Nivolumab + Ipilimumab | Anti-PD-1 antibody Anti-PD-1 antibody + Anti-CTLA-4 antibody | As monotherapy in sorafenib-experienced patients As combination therapy in sorafenib-experienced patients |