局部治疗克服了在不可切除的肝细胞癌中对目标免疫疗法组合的初级耐药性
Xiangqi Chen1,2, Mingjian Piao1, Zixiang Zhou2
1State Key Laboratory of Complex Severe and Rare Diseases, Department of Liver Surgery, Peking Union Medical College Hospital, Beijing, China.
Cancer immunology, immunotherapy : CII
|October 9, 2025
概括
在不可切除的肝细胞癌 (uHCC) 患者中,对免疫检查点抑制剂 (ICI) 的获得性耐药性 (AR) 在两年内发展,并且预后比原发性耐药性 (PR) 更好. 抗药后的治疗改善了两者的结果,特别是对AR.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 肝细胞癌研究 肝细胞癌研究
背景情况:
- 免疫检查点抑制剂 (ICI) 对不可切除的肝细胞癌 (uHCC) 是至关重要的.
- 了解抗药性模式,即原发性 (PR) 和获得性 (AR),对于优化治疗策略至关重要.
研究的目的:
- 在HHCC中对ICI组合疗法的初级 (PR) 和获得性耐药性 (AR) 的特征.
- 评估与PR和AR相关的管理和预后.
主要方法:
- 对接受ICI联合治疗的HHCC患者的回顾性分析.
- 评估基线特征,进展模式,抗药后管理和整体存活率 (OS).
主要成果:
- 71.8%的患者发展了耐药性 (35.1%的PR,36.6%的AR);AR在2年内出现.
- 与PR (8.63个月) 相比,AR患者表现出更好的预后因素和更长的中位数生存期 (25.8个月).
- 随后的疗法,包括局部治疗和ICI治疗方案的改变,在PR和AR组中改善了OS,在AR中益处更大.
结论:
- 获得性耐药性 (AR) 通常在ICI治疗开始后两年内表现出来.
- AR与更有利的患者特征,不那么积极的进展和优越的预后相比初级耐药性 (PR) 相关.
- 像随后的局部治疗和修改的ICI疗法等策略在克服初级耐药性 (PR) 方面表现有前途.
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