Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Medicine, Weill Cornell Medical College, New York, New York.
Cancer. 2019 Oct 1;125(19):3312-3319. doi: 10.1002/cncr.32076. Epub 2019 Jul 10.
The position of immunotherapy as a pillar of systemic cancer treatment has been firmly established over the past decade. Immune checkpoint inhibitors are a welcome option for patients with different malignancies. This is in part because they offer the possibility of durable benefit, even for patients who have failed other treatment modalities. The recent demonstration that immunotherapy is effective for patients with hepatocellular carcinoma (HCC) is a milestone in the history of this recalcitrant disease. The treatment of HCC has been a challenge, and for many years was limited to the tyrosine kinase inhibitor sorafenib and to several novel tyrosine kinase inhibitors that have shown efficacy and have been approved. The current role of immune checkpoint inhibitors in the management of HCC, and how this role is likely to evolve in the years ahead, are key. Other than efforts evaluating single checkpoint inhibitors, potential combination strategies, including combinations with existing local and systemic approaches, including novel therapies are evolving. This is understandably of special interest considering the potential unique immune system of the liver, which may impact the use of immunotherapy in patients with HCC going forward, and how can it be enhanced further.
在过去的十年中,免疫疗法作为全身癌症治疗的支柱地位已经得到了确立。免疫检查点抑制剂是不同恶性肿瘤患者的一个受欢迎的选择。部分原因是它们提供了持久获益的可能性,即使是那些已经对其他治疗方式产生耐药的患者。最近,免疫疗法对肝细胞癌(HCC)患者有效的证明是这种难治性疾病历史上的一个里程碑。HCC 的治疗一直是一个挑战,多年来仅限于酪氨酸激酶抑制剂索拉非尼和几种已证明疗效并获得批准的新型酪氨酸激酶抑制剂。目前免疫检查点抑制剂在 HCC 管理中的作用,以及未来几年这一作用可能如何演变,是关键。除了评估单检查点抑制剂的努力外,还在不断探索潜在的联合策略,包括与现有的局部和全身治疗方法(包括新型疗法)的联合。考虑到肝脏独特的免疫系统,这一点特别令人感兴趣,因为它可能会影响未来 HCC 患者免疫治疗的应用,以及如何进一步增强这种免疫治疗。
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