Authors' Affiliation: GI-Malignancy Section, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland.
Clin Cancer Res. 2013 Dec 15;19(24):6678-85. doi: 10.1158/1078-0432.CCR-13-1721. Epub 2013 Sep 12.
Hepatocellular carcinoma is the third most common cancer worldwide. It is an inflammation-associated cancer. Multiple investigators have demonstrated that analysis of the tumor microenvironment may be used to predict patient outcome, indicating the importance of local immune responses in this disease. In contrast with other types of cancer, in which surgery, radiation, and systemic cytotoxic chemotherapies dominate the treatment options, in hepatocellular carcinoma locoregional treatments are widely applied. Such treatments induce rapid tumor cell death and antitumor immune responses, which may favor or impair the patients' outcome. Recent immunotherapeutic studies demonstrating promising results include trials evaluating intratumoral injection of an oncolytic virus expressing granulocyte macrophage colony-stimulating factor, glypican-3 targeting treatments, and anti-CTLA4 treatment. Although some of these novel approaches may provide benefit as single agents, there is a clear opportunity in hepatocellular carcinoma to evaluate these in combination with the standard modalities to more effectively harness the immune response.
肝细胞癌是全球第三大常见癌症。它是一种与炎症相关的癌症。多位研究人员已经证明，对肿瘤微环境的分析可用于预测患者的预后，这表明局部免疫反应在这种疾病中的重要性。与其他类型的癌症不同，在其他类型的癌症中，手术、放疗和全身细胞毒性化疗是主要的治疗选择，而在肝细胞癌中，局部治疗被广泛应用。这些治疗方法会导致肿瘤细胞迅速死亡和抗肿瘤免疫反应，这可能有利于或不利于患者的预后。最近的免疫治疗研究表明，包括评估表达粒细胞巨噬细胞集落刺激因子的溶瘤病毒瘤内注射、针对磷脂酰聚糖-3 的治疗和抗 CTLA4 治疗的试验，都取得了有希望的结果。虽然这些新方法中的一些作为单一药物可能会带来益处，但在肝细胞癌中，有一个明确的机会来评估它们与标准治疗方法的联合应用，以更有效地利用免疫反应。
