Longo Vito, Brunetti Oronzo, Gnoni Antonio, Licchetta Antonella, Delcuratolo Sabina, Memeo Riccardo, Solimando Antonio Giovanni, Argentiero Antonella
Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy.
Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy.
Medicina (Kaunas). 2019 Oct 17;55(10):698. doi: 10.3390/medicina55100698.
Hepatocellular carcinoma is the most common primary liver cancer and the fourth leading cause of cancer death worldwide. A total of 70-80% of patients are diagnosed at an advanced stage with a dismal prognosis. Sorafenib had been the standardcare for almost a decade until 2018 when the Food and Drug Administration approved an alternative first-line agent namely lenvatinib. Cabozantinib, regorafenib, and ramucirumab also displayed promising results in second line settings. FOLFOX4, however, results inan alternative first-line treatment for the Chineseclinical oncology guidelines. Moreover,nivolumab and pembrolizumab,two therapeutics against the Programmed death (PD)-ligand 1 (PD-L1)/PD1 axis have been recently approvedfor subsequent-line therapy. However, similar to other solid tumors, the response rate of single agent targeting PD-L1/PD1 axis is low. Therefore, a lot of combinatory approaches are under investigation, including the combination of different immune checkpoint inhibitors (ICIs), the addition of ICIs after resection or during loco-regional therapy, ICIs in addition to kinase inhibitors, anti-angiogenic therapeutics, and others. This review focuses on the use of ICIs for the hepatocellular carcinoma with a careful assessmentof new ICIs-based combinatory approaches.
肝细胞癌是最常见的原发性肝癌,也是全球癌症死亡的第四大主要原因。共有70%-80%的患者在晚期被诊断出来,预后不佳。在2018年美国食品药品监督管理局批准另一种一线药物乐伐替尼之前,索拉非尼一直是近十年的标准治疗药物。卡博替尼、瑞戈非尼和雷莫西尤单抗在二线治疗中也显示出了有前景的结果。然而,FOLFOX4是中国临床肿瘤学会指南中的一种一线替代治疗方案。此外,纳武利尤单抗和帕博利珠单抗这两种针对程序性死亡(PD)-配体1(PD-L1)/PD1轴的治疗药物最近已被批准用于后续治疗。然而,与其他实体瘤类似,单药靶向PD-L1/PD1轴的缓解率较低。因此,许多联合治疗方法正在研究中,包括不同免疫检查点抑制剂(ICI)的联合、切除术后或局部区域治疗期间添加ICI、ICI联合激酶抑制剂、抗血管生成治疗药物等。本综述重点关注ICI在肝细胞癌中的应用,并仔细评估基于ICI的新联合治疗方法。
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