Mazzolini Guillermo D, Malvicini Mariana
Laboratorio de Terapia Génica, Instituto de Investigaciones en Medicina Traslacional (IIMT), Facultad de Ciencias Biomédicas, CONICET- Universidad Austral, Buenos Aires, Argentina. E-mail:
Laboratorio de Terapia Génica, Instituto de Investigaciones en Medicina Traslacional (IIMT), Facultad de Ciencias Biomédicas, CONICET- Universidad Austral, Buenos Aires, Argentina.
Medicina (B Aires). 2018;78(1):29-32.
Hepatocellular carcinoma (HCC) is the second cause of cancer-related death in the world and is the main cause of death in cirrhotic patients. Unfortunately, the incidence of HCC has grown significantly in the last decade. Curative treatments such as surgery, liver transplantation or percutaneous ablation can only be applied in less than 30% of cases. The multikinase inhibitor sorafenib is the first line therapy for advanced HCC. Regorafenib is the standard of care for second-line patients. However, novel and more specific potent therapeutic approaches for advanced HCC are still needed. The liver constitutes a unique immunological microenvironment, although anti-tumor immunity seems to be feasible with the use of checkpoint inhibitors such as nivolumab. Efficacy may be further increased by combining checkpoint inhibitors or by applying loco-regional treatments. The success of immune checkpoint blockade has renewed interest in immunotherapy in HCC.
肝细胞癌（HCC）是全球癌症相关死亡的第二大原因，也是肝硬化患者的主要死因。不幸的是，在过去十年中，HCC的发病率显著上升。诸如手术、肝移植或经皮消融等根治性治疗仅适用于不到30%的病例。多激酶抑制剂索拉非尼是晚期HCC的一线治疗药物。瑞戈非尼是二线患者的标准治疗药物。然而，对于晚期HCC，仍需要新颖且更具特异性的有效治疗方法。肝脏构成了独特的免疫微环境，尽管使用诸如纳武单抗等检查点抑制剂似乎可行，但抗肿瘤免疫疗法仍有待进一步探索。通过联合使用检查点抑制剂或应用局部区域治疗，疗效可能会进一步提高。免疫检查点阻断的成功重新激发了人们对HCC免疫治疗的兴趣。
