肝细胞癌中全身疗法的演变作用:新辅助和辅助策略
Ho Soo Chun1,2, Minjong Lee1,2, Tae Hun Kim1,2
1Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Journal of liver cancer
|June 16, 2025
概括
辅助性和新辅助性系统性疗法在手术后改善早期肝细胞癌 (HCC) 的结果方面表现有前途,尽管试验结果混杂. 目前正在进行的研究正在探索这些策略,以减少高复发率.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 医学瘤学 医学瘤学
- 翻译性癌症研究
背景情况:
- 手术切除提供了早期肝细胞癌 (HCC) 的长期存活,但复发率可以在5年内达到70%.
- 以前的辅助疗法,如索拉芬尼,并没有显著改善无复发存活率 (RFS) 或整体存活率.
- 系统性治疗的最新进展,包括免疫检查点抑制剂和氨酸激酶抑制剂,正在使HCC的辅助和新辅助治疗策略恢复活力.
研究的目的:
- 对早期肝细胞癌 (HCC) 的新辅助和辅助系统疗法的不断变化的格局进行审查.
- 讨论新型系统性药物的潜力,以改善可切除的HCC.
- 突出系统疗法在切除或肝移植下降阶段的作用.
主要方法:
- 对最近的临床试验和1/2期研究的综述,这些研究在HCC的新辅助/辅助环境中研究了全身疗法.
- 分析来自IMBrave050等试验的结果,评估阿特佐利祖马布加贝瓦西祖马布.
- 探索全身疗法作为肝移植或切除的降级策略.
主要成果:
- 虽然IMBrave050试验没有显示RFS显著改善辅助剂阿特佐利祖马布和贝瓦齐祖马布,其他正在进行的试验正在调查类似的方法.
- 阶段1/2试验表明,新辅助和辅助系统治疗的客观响应率很高.
- 系统疗法正在越来越多地研究下降阶段的HCC,以提高切除或肝移植的资格.
结论:
- 新辅助和辅助系统疗法代表了改善早期HCC结果的有希望的前沿,特别是在高风险患者中.
- 尽管有一些试验挫折,但该领域正在迅速发展,正在对新型系统性药物进行调查.
- 多学科的方法对于整合这些复杂的策略和优化HCC治疗决策至关重要.
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