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在肝细胞癌中,新辅助向治疗加上跨动脉化学栓塞与包括免疫治疗在内的三重治疗进行比较:一项中国多中心研究

Hao Yu¹, Quan Yuan², Rui Yu³

¹Department of Hepato-Biliary-Pancreatic and Vascular Surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.

Cancer immunology, immunotherapy : CII

|August 26, 2025

概括

与双重治疗方案相比,三重治疗,结合跨动脉化学栓塞 (TACE),向药物和免疫治疗,显著改善了接受新辅助治疗 (NAT) 的肝细胞癌 (HCC) 患者的存活率.

科学领域:

肝胆外科手术
医学瘤学
癌症研究

背景情况:

新辅助疗法 (NAT) 对于改善边缘切除性肝细胞癌 (HCC) 的结果至关重要.
目前针对HCC的NAT策略,包括向治疗,TACE,免疫治疗和放射治疗,缺乏明确的最佳治疗方案.
确定最有效的NAT方法对于提高患者的生存率和治疗疗效至关重要.

研究的目的:

在接受手术切除的HCC患者中比较双疗法与三疗法新辅助疗法的疗效.
在接受不同NAT组合的HCK患者中评估生存结果并确定预后因素.
评估中国肝癌 (CNLC) 和巴塞罗那诊所肝癌 (BCLC) 阶段系统在分层HCC患者预后中的性能.

主要方法:

一项多中心的回顾性研究,涉及64名HCC患者,这些患者在2020年至2024年期间接受了NAT,随后进行了切除.
患者被分为双疗法 (TACE + 向药物) 和三疗法 (TACE + 向药物 + 免疫疗法) 组.
使用卡普兰-梅尔和考克斯的比例危险模型分析了生存结果.

主要成果:

与双重治疗相比,三重治疗显著改善了无进展生存 (PFS) 和整体生存 (OS) (PFS HR=0. 450,P=0. 048;OS HR=0. 437,P=0. 039).
有利的预后因素包括三重疗法,较低的瘤负担和较高的病理反应.
血管侵袭和阿尔法胎蛋白 (AFP) 的升高与较差的结果有关. 在该队列中,CNLC分期系统显示出比BCLC系统更好的预后分层.

结论:

与双重治疗相比,TACE,向药物和免疫治疗的三重治疗代表了HCC的优越新辅助治疗策略.
这些发现为优化HCC的NAT疗法提供了宝贵的见解,有可能改善患者的预后.
这项研究强调了像CNLC这样的综合分期系统对于接受新辅助治疗的HCC患者预测结果的重要性.

关键词:

中国肝癌分期系统肝细胞癌免疫检查点抑制剂主要的病理反应新辅助疗法通过动脉化学栓塞

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