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Unmet needs in the Treatment of Advanced Hepatocellular Carcinoma
Byoung Kuk Jang(장병국) 한국간담췌외과학회 2014 한국간담췌외과학회 학술대회지 Vol.2014 No.4
According to the Barcelona Clinic Liver Cancer staging system (BCLC), the current standard treatment for patients with advanced hepatocellular carcinoma is sorafenib. However, the survival gain is still unsatisfactory. Therefore, novel systemic molecular targeted agent and their combinations or combining other forms of therapies are needed.
Hepatocellular carcinoma: Current trends in NAFLD
장병국 ( Byoung Kuk Jang ) 대한간학회 2016 간학회 싱글토픽 심포지움 Vol.2016 No.2
Non alcoholic fatty liver disease (NAFLD) already has become the most common chronic liver disease in the world. NAFLD encompasses simple hepatic steatosis to non alcoholic steatohepatitis (NASH) with necroinflammation, ballooning and fibrosis which may progress to cirrhosis with accumulation of fibrosis. Several studies reported that the cumulative incidence of hepatocellular carcinoma (HCC) in NASH cirrhosis ranges between 2.4-12.8% over a 3.2-7.2 years period. Recently, the development of HCC in non cirrhotic patients with NAFLD is increasingly reported. Therefore, the concept that HCC is a complication of NAFLD related cirrhosis has been changed. The major risk factors, obesity, diabetes and metabolic syndrome were closely related with development of HCC in NAFLD patients. The further understandings about the molecular mechanism of HCC development in NAFLD are needed in the future.
장병국 ( Byoung Kuk Jang ) 대한간학회 2016 Postgraduate Courses (PG) Vol.2016 No.1
Lifestyle modification including behavioral, dietary, exercise change is ideal therapeutic option for the treatment of non-alcoholic fatty liver disease (NAFLD). However, NAFLD patients have low compliance with physical exercise and poor adherence to healthy behavior in their lifetime. Therefore, lifestyle modification is difficult to achieve the therapeutic goal for treatment of NAFLD. For these reasons, development of effective and safe new agents for NAFLD, especially for non-alcoholic steatohepatitis (NASH) treatment is eagerly needed. Recently, several new agents for NASH treatment are in development. This review focuses on present and new agents for treatment of NASH.
장병국 ( Byoung Kuk Jang ) 대한간학회 2018 간학회 싱글토픽 심포지움 Vol.2018 No.1
Non-alcoholic fatty liver disease (NAFLD) has already been the most important cause of chronic liver disease, but effective therapeutic agents have not been developed until now. Currently, several guidelines recommend vitamin E and pioglitazone as a treatment for non-alcoholic steatohepatitis (NASH) without diabetes and cirrhosis. However, vitamin E and pioglitazone were effective in the treatment of steatosis, lobular inflammation, ballooning and loss of NASH, but did not improve fibrosis. In addition, these agents are recommended only for patients with histologically diagnosed NASH without diabetes and cirrhosis, and there are limitations on their use due to various complications. Recently, various pharmacologic agents that act on specific mechanisms have been developed and under clinical studies. Therefore, it is expected that a time will soon come to treat NASH using these pharmacologic agents. However, it will take a longer time to see clear results of treatment with these drugs to prevent progression of NASH and cardiovascular complications associated with NASH and to increase survival rate.