肝癌是世界上第六大最常见癌症和第三大癌症死亡原因，而肝细胞癌（HCC）是最常见的肝癌形式。超过一半的 HCC 患者确诊时已处于晚期，通常需要全身治疗。受体酪氨酸激酶（RTK）活性失调参与HCC的发生和进展，因此RTK是晚期HCC（aHCC）全身治疗的潜在靶点。目前，共有六种小分子酪氨酸激酶抑制剂（TKI）被批准用于治疗aHCC，包括一线索拉非尼、仑伐替尼和多纳非尼，以及二线瑞戈非尼、卡博替尼和阿帕替尼。这些 TKI 改善了患者的生存率，这与疾病分期、病因、肝功能、肿瘤负荷、甲胎蛋白基线水平和治疗史有关。本综述重点关注这些 TKI 在关键临床试验、回顾性和真实世界研究中的临床结果，并讨论 TKI 治疗 aHCC 的未来前景，旨在为 aHCC 的治疗决策提供最新证据。 aHCC.© 2024。作者。

Liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer death in the world, and hepatocellular carcinoma (HCC) is the most common form of liver cancer. More than half of the HCC patients are diagnosed at an advanced stage and often require systemic therapy. Dysregulation of the activity of receptor tyrosine kinases (RTKs) is involved in the development and progress of HCC, RTKs are therefore the potential targets for systemic therapy of advanced HCC (aHCC). Currently, a total of six small molecule tyrosine kinase inhibitors (TKIs) have been approved for aHCC, including first-line sorafenib, lenvatinib, and donafenib, and second-line regorafenib, cabozantinib, and apatinib. These TKIs improved patients survival, which are associated with disease stage, etiology, liver function, tumor burden, baseline levels of alpha-fetoprotein, and treatment history. This review focuses on the clinical outcomes of these TKIs in key clinical trials, retrospective and real-world studies and discusses the future perspectives of TKIs for aHCC, with an aim to provide up-to-date evidence for decision-making in the treatment of aHCC.© 2024. The Author(s).