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对于最初无法切除的肝细胞癌的系统转化疗法:系统性审查和元分析

Hongwei Xu¹, Haili Zhang¹, Bo Li¹

¹Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, Wu hou District, Chengdu, 610041, China.

|August 14, 2024

概括

氨酸激酶抑制剂 (TKI) 加上抗PD-1疗法和局部区域疗法 (LRT) 为不可切除的肝细胞癌 (HCC) 提供了优异的结果. 这种组合,特别是伦瓦提尼布加抗PD-1和LRT,改善了转换手术率和存活率.

科学领域:

肝胆瘤学肝胆瘤学
翻译癌症研究翻译癌症研究
系统性疗法是一种全身疗法.

背景情况:

系统转化疗法对于最初无法切除的肝细胞癌 (HCC) 是至关重要的,可以切除肝脏并改善存活率.
对HCC的最佳转换策略仍然是积极调查的领域.

研究的目的:

系统地评估和比较各种转化疗法策略对不可切除的HCC的疗效.
确定最有效的组合疗法,以促进手术切除和改善患者的生存率.

主要方法:

在主要数据库 (PubMed,EMBASE,Web of Science,Scopus,Cochrane Library) 中从2007年至2024年进行了系统的文献搜索.
研究根据治疗组进行分类:TKI,TKI+LRT,TKI+anti-PD-1,TKI+anti-PD-1+LRT,ICI+LRT,以及阿特佐利祖马布+贝瓦西祖马布.
分析的关键结果包括转换到手术率 (CSR),客观反应率 (ORR),不良事件,总生存率 (OS) 和无进展生存率 (PFS).

主要成果:

分析了38项涉及4042名患者的研究.
在TKI+anti-PD-1+LRT组显示高聚合CSR33% (95%CI,25-41%).
伦瓦丁尼布+抗PD-1+LRT显示出高于35%的CSR和70%的ORR,与单独的全身疗法相比,具有良好的OS和PFS结果.

结论:

与氨酸激酶抑制剂 (TKI) 加上抗PD-1和局部区域疗法 (LRT) 的组合疗法代表了对不可切除的HCC的有希望的策略.
伦瓦替尼与抗PD-1和LRT组合似乎是最有效的治疗方案,提供可管理的安全性.
成功的转化疗法显著改善了HCC患者的整体存活率和无进展存活率.

关键词:

转化疗法是一种转化疗法.肝细胞癌是肝细胞癌.免疫治疗是一种免疫疗法.进行元分析分析.有针对性的治疗.铁氨酸激酶抑制剂铁氨酸激酶抑制剂

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