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Ou D–L et al. – Sorafenib has proved survival benefit for patients with advanced hepatocellular carcinoma (HCC). This study explored whether the efficacy of sorafenib can be improved by adding the mitogen–activated protein kinase/extracellular signal–regulated kinase (ERK) kinase (MEK) inhibitor CI–1040 to vertically block the Raf/MEK/ERK pathway. The antitumor effects of sorafenib in HCC can be improved by vertical blockade of Raf/MEK/ERK signaling with CI–1040.

Exclusive Author Commentary
Chiun Hsu, 09/15/09

Sorafenib can prolong survival in patients with advanced hepatocellular carcinoma (HCC). We demonstrated that the therapeutic efficacy of sorafenib can be improved by combining sorafenib and the MEK inhibitor CI-1040 using in vitro and in vivo HCC models. Induction of Bim protein level, which was regulated by ERK, might contribute to the drug synergy. These data provide insight on how sorafenib works in HCC and the rationale how vertical blockade of the Raf/MEK/ERK signaling pathway may be used in future clinical trials.

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