The results of the sharp trial established sorafenib, a tyrosine kinase inhibitor (tki), as the sole first-line treatment option in advanced hepatocellular carcinoma (hcc) for more than a decade. In 2020, there has been a surge in new therapies for hcc, including immunotherapeutic strategies and the approval of a number of novel tkis. In addition to sorafenib, lenvatinib and combination atezolizumab-bevacizumab now represent standard first-line treatment options. As those systemic therapy options begin to be better utilized, assurance of adequate liver function and optimal timing are required to improve patient outcomes. Furthermore, sequencing of the agents will have to be carefully tailored, given the increasing armamentarium of choices. Here, we discuss the role of lenvatinib and sorafenib in the first-line management of hcc.

中文翻译：

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肝细胞癌一线治疗的非免疫疗法选择：探索索拉非尼和乐伐替尼在晚期疾病中的作用

敏锐的试验结果表明，索拉非尼是一种酪氨酸激酶抑制剂 (tki)，十多年来一直是晚期肝细胞癌 (hcc) 的唯一一线治疗选择。2020 年，hcc 的新疗法激增，包括免疫治疗策略和许多新型 tki 的批准。除了索拉非尼，乐伐替尼和联合阿特珠单抗-贝伐珠单抗现在代表标准的一线治疗选择。随着这些全身治疗方案开始得到更好的利用，需要保证足够的肝功能和最佳时机来改善患者的预后。此外，考虑到越来越多的选择，必须仔细调整代理的排序。在这里，我们讨论乐伐替尼和索拉非尼在 hcc 一线治疗中的作用。