Gerbes Alexander, Zoulim Fabien, Tilg Herbert, Dufour Jean-François, Bruix Jordi, Paradis Valérie, Salem Riad, Peck-Radosavljevic Markus, Galle Peter R, Greten Tim F, Nault Jean-Charles, Avila Matias A
Department of Medicine 2, Liver Center Munich, University Hospital, LMU, Munich, Germany.
Hepatology Department at the Hospices Civils de Lyon, Lyon University, Institut Universitaire de France, Lyon, France.
Gut. 2018 Feb;67(2):380-388. doi: 10.1136/gutjnl-2017-315068. Epub 2017 Nov 17.
Hepatocellular carcinoma (HCC) ranks number three among the most frequent causes of death from solid tumors worldwide. With obesity and fatty liver diseases as risk factors on the rise, HCC represents an ever increasing challenge. While there is still no curative treatment for most patients numerous novel drugs have been proposed, but most ultimately failed in phase III trials. This manuscript targets therapeutic advances and most burning issues. Expert key point summaries and urgent research agenda are provided regarding risk factors, including microbiota, need for prognostic and predictive biomarkers and the equivocal role of liver biopsy. Therapeutic topics highlighted are locoregional techniques, combination therapies and the potential of immunotherapy. Finally the manuscript provides a critical evaluation of novel targets and strategies for personalized treatment of HCC.
肝细胞癌（HCC）是全球实体瘤致死的第三大常见原因。随着肥胖和脂肪性肝病等危险因素不断增加，HCC带来的挑战日益严峻。虽然大多数患者仍无治愈性疗法，但已有众多新型药物被提出，然而大多数最终在III期试验中失败。本文针对治疗进展和最紧迫的问题展开探讨。文中提供了专家要点总结以及关于危险因素的紧迫研究议程，包括微生物群、对预后和预测生物标志物的需求以及肝活检的模糊作用。重点突出的治疗主题包括局部区域技术、联合疗法以及免疫疗法的潜力。最后，本文对HCC个性化治疗的新靶点和策略进行了批判性评估。
