Oncology Frontier: So for those patients with hepatitis， cirrhotic or non-cirrhotic， is it a hierarchy of attacking the virus first and then the cirrhosis or vice versa?

　　《肿瘤瞭望》：治疗肝炎（发生了肝硬化或未发生肝硬化）是应该先进行抗病毒治疗，还是先治疗肝硬化？

　　Dr Kim: That’s a very good question and I don’t have an answer for that. Certainly it is a combination of the two. Patients that benefit more are those with cirrhosis because they have the double whammy. We turn off the virus， which reduces the impact， and then we reverse cirrhosis which further reduces the risk.

　　Kim博士：这是一个非常好的问题，但我还没有明确的答案。当然是抗病毒治疗和肝硬化治疗二者联合，关掉病毒，同时逆转肝硬化会进一步降低HCC癌变风险。其中，发生肝硬化的患者会受益更多，因为他们受到了肝炎病毒和肝硬化的双重打击。

　　Oncology Frontier: Can you talk about the therapeutics involved in treating hepatitis B and hepatitis C?

　　《肿瘤瞭望》：您能否谈谈乙型肝炎和丙型肝炎的治疗方法？

　　Dr Kim: Hepatitis B is easier to talk about because the current choices are two – entecavir and tenofovir. They are very effective and very potent and not prone to the emergence of resistant mutations of the virus. They can be used for a long time and can be expected to be effective throughout. We see many patients responding to that without breakthroughs. Hepatitis C treatment is harder to talk about because it is changing all the time. Just for 2014， the FDA approved three different regimens for hepatitis C and there are a few more coming down the pipeline. What will be the treatment of choice and what will be most attractive in terms of cancer risk reduction， needs to be constantly updated.

　　Kim博士：目前乙型肝炎治疗选择有两个：恩替卡韦和替诺福韦，两种药物的效果都很好，不容易导致HBV耐药性突变，可以长时间使用，并且一直有效。丙型肝炎治疗药物一直在变，仅仅在2014年，FDA就批准了三种不同的丙型肝炎治疗药物，目前还有一些药物正在审批中。丙型肝炎怎么治疗，哪种方法治疗丙型肝炎能减少癌变还需要研究证明。

　　Oncology Frontier: Does that regimen change if the patient also has HCC?

　　《肿瘤瞭望》：如果患者已经患有HCC，以上肝炎治疗方法需不需要改变？

　　Dr Kim: We don’t know that. The bottom line is the regimen that is most effective at getting rid of hepatitis C would be the therapy of choice. My bias is that it would be unlikely that the chemical structure of the specific regimens will have bearing on its effectiveness for cancer prevention. It is more about the brute force of eliminating the virus that will be the determining factor.

　　Kim博士：这一点目前还不清楚。方案要不要改变，前提是治疗方案对丙型肝炎有效。我的观点是，以药物化学结构来预防癌症不太可能，强力消除病毒才是预防HCC的决定因素。

　　Oncology Frontier: When it comes to drug therapy， apart from sorafenib， are there any other effective drugs that you would recommend for HCC treatment?

　　《肿瘤瞭望》：谈到HCC治疗，除了索拉非尼，还有没有其他有效的药物？

　　Dr Kim: Right now， there isn’t anything approved. We just saw a presentation on the REACH study， which was overall negative. Sorafenib set the bar and subsequent molecules have not been successful in overcoming that threshold.

　　Kim博士：现在还没有已经批准的肝癌治疗药物。这次会议上公布了REACH研究结果，但基本是阴性结果。目前还没有别的分子靶向药物能超过索拉非尼（Sorafenib）的疗效。