Abstracts Poster Abstracts - Dr Falk

treatment approach with HDACi together with apoptosis inducing agents, such asdeath receptor ligands like TRAIL, or classical chemotherapeuticals merits furtherevaluation in pre-clinical and clinical studies.Antiangiogenic approachesIt was Judah Folkman back in 1971, who firstly described the idea of blocking vesselformation as a therapeutical principle to fight tumor growth. It took 3 decades until themonoclonal antibody bevacizumab an anti-angiogenic biological entered successfullythe clinical stage as part of treatment patients with colon carcinoma. Bevacizumabtargets soluble VEGF and there is evidence from pre-clinical studies that also in HCCanimal models, directly interfering with the VEGF system reduces tumor growth.However, interfering with angiogenesis probably will not be enough - in a phase IItrial, treatment with thalidomide, which down-regulates VEGF production, resulted instable disease in one third of the patients only. Sorafenib, a small molecule whichinhibits VEGF and raf kinase signaling, showed initial anti-tumor activity and is nowtested in a randomized phase III trial in patients with advanced HCC.ConclusionTreatment of patients with HCC remains a clinical challenge. New approaches, whichtarget the Achilles' heel of HCC namely its resistance towards killer cells andapoptosis as well as its hypervascularity, are about to enter the clinical stage. Due tothe usually underlying liver disease, HCC patients will remain a difficult-to-treat andheterogeneous population - we will have to work on our partners in the pharmaceuticalindustry to support more strongly the transfer of promising preclinical resultsinto randomized trials with our patients.75