EC Clinical and Medical Case Reports

Hepatocellular carcinoma (HCC) is the second cause of worldwide mortality among cancer patients with over 800 deaths annually. The major cases of HCC associated with hepatitis B and C viruses. Direct-acting antiviral agents (DAA) has become a breakthrough in the treatment of HCV infection. Short-term oral DAA administration results in more than 95% of effective virus elimination. However, the impact of DAA- on HCC has not been thoroughly studied. HCC is the second cause of mortality among cancer patients with the incidence rate being increased worldwide including Russia. About one half of patients with HCC commonly receive Sorafenib or Lenvatinib as first-line or regorafenib, cabosantinib or ramucirumab as second-line-therapy. Immune CPI have been an outstanding advance in the treatment of HCC for the last five years. The combination of Atezolizumab and Bevacizumab appears to be standard therapy for HCC as it was shown to increase the overall survival rate compared with Sorafenib alone [1]. The combined therapy based on CPI is preferable in all HCC stages. It was also shown that durvalumab combined with tremelimumab resulted in better overall survival compared with sorafenib alone, at the same time atezolizumab in combination with cabozantinib demonstrated better progression-free survival. In addition, pembrolizumab as monotherapy and nivolumab combined with ipilimumab managed to win a outbreaking FDA approval as second-line HCC chemotherapy [2,3]. Development of DAA appears to be a breakthrough in the HCV treatment. Short-term oral DAA administration results in more than 95% of effective virus elimination. The impact of DAA on the HCC has not been carefully studied. It can be attributed to the fact that two different categories of CHC patients were commonly included in the CPI-clinical trials: those without previous antiviral therapy (AVT) or those who had previously had effective AVT if the interval between the end of AVT and the start of CPI was not less than four weeks.

Keywords: Direct Acting Antivirals (DAA); Check-Point Inhibition (CPI); Hepatocellular Carcinoma (HCC); Antiviral Therapy (AVT)

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