Gottlieb Aline, Best Jan, Canbay Ali
Department of Gastroenterology, Hepatology, and Infectious Diseases, University Hospital Magdeburg, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Visc Med. 2019 Mar;35(1):18-26. doi: 10.1159/000496755. Epub 2019 Feb 8.
Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer-related death worldwide. Upon ineligibility for resection, liver transplantation, or locoregional therapies, sorafenib has been the only systemic treatment option of advanced HCC for more than a decade. Immunotherapy is an evolving HCC treatment option that has shown promise in treatment efficacy at an acceptable safety profile during several preceding phase I/II trials. Numerous clinical trials of immune checkpoint inhibitors (ICPIs) alone, in combination of two, or combined with other targeted or locoregional therapies are ongoing. Encouraging results of two-phase III trials testing pembrolizumab or nivolumab versus standard care therapy even resulted in Food and Drug Administration approval for second-line treatment of advanced HCC. ICPIs may open new avenues to the treatment of hepatobiliary tumors, alone or in combination.
肝细胞癌（HCC）仍然是全球癌症相关死亡的主要原因之一。在无法进行手术切除、肝移植或局部区域治疗时，十多年来索拉非尼一直是晚期HCC唯一的全身治疗选择。免疫疗法是一种不断发展的HCC治疗选择，在前几个I/II期试验中已显示出在可接受的安全性方面具有治疗效果的前景。目前正在进行许多关于单独使用免疫检查点抑制剂（ICPI）、两种联合使用或与其他靶向或局部区域疗法联合使用的临床试验。两项测试帕博利珠单抗或纳武利尤单抗与标准护理疗法对比的III期试验取得了令人鼓舞的结果，甚至促使美国食品药品监督管理局批准其用于晚期HCC的二线治疗。ICPI单独或联合使用可能为肝胆肿瘤的治疗开辟新途径。
