突破跨动脉化学栓塞阻力障碍:通过三重疗法重塑晚期肝癌的治疗途径
Su-Ming Shi1, Qing-Qing Zhou2, Yi-Meng Ren3
1ENT Institute, Department of Otorhinolaryngology, Eye and ENT Hospital, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China.
World journal of clinical oncology
|December 8, 2025
概括
结合跨动脉化学栓塞 (TACE),PD-L1抑制剂和向治疗的三重疗法在晚期肝癌中显著克服了TACE抵抗. 这种综合方法改善了生存结果,并推进了治疗模式.
科学领域:
- 肝胆道手术 肝胆道手术
- 医学瘤学 医学瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 晚期肝细胞癌 (HCC) 往往表现出对跨动脉化学栓塞 (TACE) 的抗性.
- 需要新的治疗策略来改善TACE耐药HCC的治疗结果.
- 了解TACE,免疫反应和血管再生之间的相互作用至关重要.
研究的目的:
- 评估三重治疗方案 (TACE + PD-L1 抑制剂 + 分子向治疗) 在克服晚期HCC中TACE耐药性的疗效.
- 为了确定治疗反应和生存的预测因素在先进的HCC.
主要方法:
- 用三重治疗方案治疗的晚期HCC患者的回顾性分析.
- 三重疗法和单独TACE之间的结果比较.
- 确定治疗反应的独立预测因素.
主要成果:
- 三重疗法将TACE抵抗率从38.8%降低到9.7%.
- 与TACE单独相比,中位数无进展生存率增加了92.3%,中位数整体生存率增加了26.8%.
- 最大瘤直径,囊损失和双边分布被确定为独立的预测因素.
结论:
- TACE,PD-L1抑制剂和分子向治疗的组合提供了一种协同方法,以逆转 TACE 耐药性在晚期 HCC 中.
- 这种综合治疗模式代表了从局部干预转向局部系统综合方法的转变.
- 为了优化顺序治疗策略,需要进一步研究涉及交叉omics,生物标志物发现和前性试验.
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