免疫治疗后肝细胞癌的治疗方法
Landon L Chan1, Tsz Tung Kwong1, Johnny C W Yau1
1Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
Annals of hepatology
|February 10, 2025
概括
在先进的肝细胞癌 (HCC) 进行一线免疫治疗后进行最佳治疗至关重要. 本综述探讨了有效的二线疗法,包括多酶抑制剂和新方法,用于HCC进展的患者.
科学领域:
- 肝胆道癌症 肝胆道癌症
- 免疫治疗是一种免疫疗法.
- 在瘤学瘤学.
背景情况:
- 免疫疗法已经改变了晚期肝细胞癌 (HCC) 治疗方法,改善了生存率和反应率.
- 尽管免疫疗法取得了成功,但大多数患者最终会出现疾病进展,需要有效的二线策略.
- 目前的指导方针建议在免疫治疗后使用多酶抑制剂,但证据主要基于专家的共识.
研究的目的:
- 审查和讨论在第一线免疫疗法进展后晚期HCC的最佳治疗策略.
- 评估各种二线疗法的证据,包括多酶抑制剂,救援免疫疗法和分子导向剂.
- 探索新兴的方法,如在免疫疗法期间针对寡头进展的局部区域疗法.
主要方法:
- 审查当前的国际指导方针和专家对二线HCC治疗的共识.
- 对多酶抑制剂在HCC中的有效性和安全性的现实数据的分析.
- 对救援免疫疗法 (例如,抗CTLA-4) 和分子向疗法的新兴证据的审查.
- 对免疫治疗中HCC患者的寡头进展的局部/局部区域治疗数据的评估.
主要成果:
- 建议使用多酶抑制剂作为二线药物,尽管证据主要是基于共识的;现实数据表明效果与一线药物使用相似.
- 持续免疫治疗后进展的益处尚不清楚,但救援抗CTLA-4疗法显示有希望.
- 分子导向疗法最初表现有希望,但需要进一步验证.
- 在维持免疫治疗的同时,可以通过局部/局部区域治疗来控制寡进.
结论:
- 在先进的HCC的第一线免疫疗法后,治疗的最佳顺序仍然是一个不断发展的领域.
- 多酶抑制剂是标准的,尽管基于证据的,二线选择.
- 需要进一步的研究来确定持续免疫疗法,救援疗法和分子导向剂在HCC进展中的作用.
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