Aitcheson Gabriella, Pillai Anjana, Dahman Bassam, John Binu V
Department of Internal Medicine, Jackson Memorial Hospital, Miami, FL USA.
Division of Gastroenterology, University of Chicago, Chicago, IL USA.
Curr Hepatol Rep. 2021;20(1):23-33. doi: 10.1007/s11901-021-00560-2. Epub 2021 Feb 1.
This paper aims to summarize the data of recently completed and key ongoing clinical trials of systemic agents for advanced hepatocellular carcinoma (aHCC). In particular, the review focuses on ongoing checkpoint inhibitor combination trials and promising studies combining tyrosine kinase inhibitors with checkpoint inhibitors.
The recently approved combination of atezolizumab and bevacizumab based on the IMbrave150 trial has shown the most potential with the highest overall survival of any systemic agent in HCC to date, surpassing sorafenib. Despite COVID-19 delays, other promising trials that involve combining VEGF-directed therapy and checkpoint inhibition, cancer vaccines, phosphatidylserine, YIV-906, and oncolytic and immunotherapeutic vaccinia virus are actively recruiting patients.
After almost a 10-year dormancy, the list of potential systemic treatment options for aHCC is growing rapidly. Given the promising data from the IMbrave150 trial, the combination of atezolizumab and bevacizumab is now the new first-line therapy. We discuss the change in landscape, the new second- and third-line systemic treatments in aHCC, and the ongoing clinical trials for newer agents including combination therapies.
本文旨在总结近期完成的以及正在进行的晚期肝细胞癌（aHCC）全身治疗药物关键临床试验的数据。特别地，本综述聚焦于正在进行的检查点抑制剂联合试验以及将酪氨酸激酶抑制剂与检查点抑制剂联合的前景良好的研究。
基于IMbrave150试验，近期获批的阿替利珠单抗和贝伐单抗联合用药展现出了最大潜力，是目前肝癌全身治疗药物中总生存期最长的，超过了索拉非尼。尽管受到新冠疫情延误，其他前景良好的试验，包括联合VEGF靶向治疗与检查点抑制、癌症疫苗、磷脂酰丝氨酸、YIV-906以及溶瘤和免疫治疗痘苗病毒的试验，仍在积极招募患者。
在沉寂了近10年后，aHCC潜在的全身治疗选择迅速增多。鉴于IMbrave150试验的数据很有前景，阿替利珠单抗和贝伐单抗联合用药现已成为新的一线治疗方案。我们讨论了格局的变化、aHCC新的二线和三线全身治疗方法，以及包括联合疗法在内的新型药物正在进行的临床试验。
