肝细胞癌的局部区域和系统治疗方法的进展
Amit G Singal1, Riad Salem2, David J Pinato3
1Department of Internal Medicine, UT Southwestern Medical Center, Dallas TX, USA.
Gastroenterology
|May 4, 2025
概括
免疫检查点抑制剂 (ICI) 组合改善了不可切除的肝细胞癌 (HCC) 的存活率. 然而,辅助性ICI治疗并没有改善无复发生存率,突出显示了个性化治疗策略的必要性.
科学领域:
- 肝胆道癌症 肝胆道癌症
- 医学瘤学 医学瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 肝细胞癌 (HCC) 治疗的重大进展包括免疫检查点抑制剂 (ICI) 组合.
- ICI组合改善了不可切除的HCC的整体存活率 (OS),在一些患者中,中位数存活时间超过2年,长期存活时间超过5年.
研究的目的:
- 审查HCC系统疗法的不断变化的格局,特别是ICI组合.
- 解决关于在HCC管理中最佳使用,测序和综合系统性疗法的新出现的问题.
- 讨论对治疗有显著反应的患者的管理,包括肝移植.
主要方法:
- 审查最近的临床试验数据ICI组合和术后/辅助疗法对HCC.
- 结果分析包括总生存率 (OS),无复发生存率 (RFS) 和无进展生存率 (PFS).
- 关于在HCC中应用全身疗法的临床决策因素的讨论.
主要成果:
- ICI组合已经证明,对不可切除的HCC的OS有显著的改善.
- 在最近的试验中,辅助ICI治疗没有显示改善RFS.
- 在两个试验中,将ICI疗法与跨动脉化学栓塞 (TACE) 结合起来改善了PFS,尽管正在等待OS数据.
结论:
- 在HCC中辅助ICI治疗的疗效需要进一步研究.
- 将ICI与TACE结合起来,可以改善HCC的PFS.
- 个性化,多学科的方法对于确定最佳的系统性治疗序列和HCC的管理至关重要,考虑到瘤负担,肝功能和患者的目标.
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