肝细胞癌肝移植的不断变化的景观:从阶段迁移到免疫疗法革命
Silvia Cesario1, Virginia Genovesi1, Francesca Salani2
1Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy.
Life (Basel, Switzerland)
|July 29, 2023
概括
免疫检查点抑制剂在肝移植 (LT) 之前对低阶段肝细胞癌 (HCC) 有希望. 虽然21%的患者实现了客观反应,但需要进一步研究以优化安全性和疗效.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 肝移植 (LT) 是肝细胞癌 (HCC) 的首要治疗方法.
- 先进的HCC通常会排除LT,即使使用局部区域治疗.
- 免疫检查点抑制剂 (ICI) 为HCC管理提供了新的策略.
研究的目的:
- 审查ICI作为桥梁或下降阶段治疗的有效性和安全性,在HCC的LT之前.
- 评估ICI治疗后的响应率和LT的资格.
- 确定潜在的风险和未来研究领域.
主要方法:
- 系统审查病例报告和涉及HCC患者的系列,这些病例报告和系列涉及在LT之前用ICI治疗的HCC患者.
- 对客观响应率 (ORR) 和向米兰标准下调阶段的分析.
- 对LT结果的评估,包括移植排斥和患者存活率.
主要成果:
- 总共有43名患者在LT之前接受了ICI.
- 客观响应率为21%被观察到.
- 14名患者在米兰标准下进行了下降阶段;在大多数情况下,LT是安全的,但在7名患者 (4例死亡) 中发生了移植排斥.
结论:
- 国际投资基金显示出其潜力,作为HCC在LT之前的下调策略.
- 进一步的研究对于确定最佳ICI持续时间,洗期和长期安全性至关重要.
- 目前正在进行的临床试验将澄清ICI在HTCC前LT环境中的作用.
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