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不可切除肝细胞癌中免疫检查点抑制剂反应的生化预测因子。

Biochemical predictors of response to immune checkpoint inhibitors in unresectable hepatocellular carcinoma.

机构信息

Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy; Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni, 15 Bologna, Italy.

Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy; Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni, 15 Bologna, Italy.

出版信息

Cancer Treat Res Commun. 2021;27:100328. doi: 10.1016/j.ctarc.2021.100328. Epub 2021 Feb 2.


DOI:10.1016/j.ctarc.2021.100328
PMID:33549983
Abstract

Hepatocellular carcinoma (HCC) represents the most commonly diagnosed liver cancer worldwide, and the overall survival of patients with unresectable disease is poor. In the last five years, immune checkpoint inhibitors (ICIs) have revolutionized the treatment scenario of several hematological and solid tumors, and these agents have been actively explored in unresectable HCC. Firstly, promising findings of phase I and II clinical studies reporting durable responses and a tolerable safety profile have led to the assessment of ICIs as single agents in phase III clinical studies; however, the latter have provided controversial results, and the activity of ICI monotherapy seems limited to a small subgroup of patients. Conversely, the IMbrave150 trial recently showed that, among patients with previously untreated unresectable HCC, treatment with atezolizumab plus bevacizumab resulted in significantly longer overall survival and progression-free survival compared to sorafenib monotherapy. In addition, the activity of several other ICIs is under investigation, as combination immunotherapy as well as combinations of immunotherapy with antiangiogenic agents. Nonetheless, there are currently no validated predictive biomarkers able to guide treatment choice in this setting, where the identification of specific predictors of response to ICIs represents a major challenge. In this review, we aim to provide a critical overview of recent evidence on biochemical predictors of response to ICIs in patients with unresectable HCC, especially focusing on PD-L1, TMB, MSI, and other emerging biomarkers.

摘要

肝细胞癌 (HCC) 是全球最常见的肝癌,且不可切除疾病患者的总体生存率较差。在过去五年中,免疫检查点抑制剂 (ICI) 彻底改变了多种血液系统和实体瘤的治疗格局,这些药物已在不可切除 HCC 中得到积极探索。首先,具有持久反应和可耐受安全性特征的 I 期和 II 期临床研究的有前景发现促使人们将 ICI 作为单一药物进行 III 期临床研究评估;然而,后者提供了有争议的结果,ICI 单药治疗的活性似乎仅限于一小部分患者。相反,最近的 IMbrave150 试验表明,对于未曾接受过治疗的不可切除 HCC 患者,与索拉非尼单药治疗相比,阿替利珠单抗联合贝伐珠单抗治疗可显著延长总生存期和无进展生存期。此外,其他几种 ICI 的活性正在研究中,包括免疫联合治疗以及免疫联合抗血管生成药物治疗。尽管如此,目前尚无经过验证的预测性生物标志物能够指导这种情况下的治疗选择,而识别对 ICI 有反应的特定预测因子是一个主要挑战。在这篇综述中,我们旨在批判性地综述最近关于不可切除 HCC 患者对 ICI 反应的生化预测因子的证据,特别是重点关注 PD-L1、TMB、MSI 和其他新兴生物标志物。

相似文献

[1]
Biochemical predictors of response to immune checkpoint inhibitors in unresectable hepatocellular carcinoma.

Cancer Treat Res Commun. 2021

[2]
Benefits of combination therapy with immune checkpoint inhibitors and predictive role of tumour mutation burden in hepatocellular carcinoma: A systematic review and meta-analysis.

Int Immunopharmacol. 2022-11

[3]
Efficacy and Safety Associated With Immune Checkpoint Inhibitors in Unresectable Hepatocellular Carcinoma: A Meta-analysis.

JAMA Netw Open. 2021-12-1

[4]
First-line immune checkpoint inhibitor-based combinations in unresectable hepatocellular carcinoma: current management and future challenges.

Expert Rev Gastroenterol Hepatol. 2021-11

[5]
Beyond First-Line Immune Checkpoint Inhibitor Therapy in Patients With Hepatocellular Carcinoma.

Front Immunol. 2021

[6]
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Front Immunol. 2021

[7]
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Aging (Albany NY). 2020-6-24

[8]
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Hepatobiliary Pancreat Dis Int. 2022-10

[9]
PD-L1, TMB, MSI, and Other Predictors of Response to Immune Checkpoint Inhibitors in Biliary Tract Cancer.

Cancers (Basel). 2021-2-1

[10]
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J Hepatol. 2023-8

引用本文的文献

[1]
Review Article: Liver Transplantation for Hepatocellular Carcinoma in the Era of Immune Checkpoint Inhibitors.

Aliment Pharmacol Ther. 2025-9

[2]
Antiviral therapy can effectively suppress irAEs in HBV positive hepatocellular carcinoma treated with ICIs: validation based on multi machine learning.

Front Immunol. 2025-1-27

[3]
The prognostic value of the tumor-stroma ratio compared to tumor-infiltrating lymphocytes in triple-negative breast cancer: a review.

Virchows Arch. 2025-3

[4]
Immunotherapeutic Potential of the Yellow Fever Virus Vaccine Strain 17D for Intratumoral Therapy in a Murine Model of Pancreatic Cancer.

Vaccines (Basel). 2025-1-6

[5]
ZP3 Expression in Pancreatic Adenocarcinoma: Its Implications for the Prognosis and Therapy.

Protein Pept Lett. 2025

[6]
Jianpi-Huatan-Huoxue-Anshen formula ameliorates gastrointestinal inflammation and microecological imbalance in chemotherapy-treated mice transplanted with H22 hepatocellular carcinoma.

World J Gastrointest Oncol. 2024-10-15

[7]
Case report: Successful radical surgery following complete pathological remission of advanced HCC with Tislelizumab/Lenvatinib plus TACE.

Front Oncol. 2024-8-29

[8]
Biological Cargo: Exosomes and their Role in Cancer Progression and Metastasis.

Curr Top Med Chem. 2025

[9]
Prolonged Complete Remission Using Tislelizumab for Hepatocellular Carcinoma After Adjuvant Chemotherapy Failure: A Case Report.

J Hepatocell Carcinoma. 2024-6-4

[10]
Atezolizumab and Bevacizumab Combination Therapy in the Treatment of Advanced Hepatocellular Cancer.

Cancers (Basel). 2023-12-30

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