晚期肝细胞癌的全身疗法:ASCO指南更新
John D Gordan1, Erin B Kennedy2, Ghassan K Abou-Alfa3,4
1University of California, San Francisco, San Francisco, CA.
概括
新的指导方针建议阿特佐利祖马布加贝瓦齐祖马布或杜尔瓦卢马布加特梅利马布作为先进肝细胞癌 (HCC) 的一线治疗方法. 这些选择适用于患有儿童-皮格A级肝病和良好表现状况的患者.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 胃肠道医疗瘤学
- 临床实践指南 临床实践指南
背景情况:
- 晚期肝细胞癌 (HCC) 存在重大治疗挑战.
- 目前的治疗策略需要根据新出现的证据定期更新.
研究的目的:
- 为高级HCC的全身治疗提供最新的,基于证据的临床建议.
- 帮助医疗保健专业人员为HCC患者做出明智的治疗决策.
主要方法:
- 一个专家小组召开会议,更新2020年ASCO对HCC的指导方针.
- 进行了2023年10月之前发表的随机对照试验 (RCT) 的系统审查.
- 建议根据最新的证据进行了更新.
主要成果:
- 十个新的RCT被纳入了证据库.
- 阿特佐利祖马布加贝瓦齐祖马布 (阿特佐+贝夫) 和杜尔瓦卢马布加特雷梅利穆马布 (杜尔瓦+特雷梅) 是推的第一线选择,适用于符合条件的高级HCC患者 (Child-Pugh A, ECOG 0-1).
- 替代的第一线疗法包括索拉费尼布,伦瓦提尼布或杜尔瓦卢马布,如果存在禁忌.
结论:
- 更新的指南提供了先进的HCC的顺序治疗方法,包括一线,二线和三线全身疗法.
- 为各种治疗线提供了具体建议,考虑到患者的表现状况和肝功能 (Child-Pugh A与B).
- 建议对患有Child-Pugh B级高级HCC的患者采取谨慎的系统治疗方法.
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