Cancer Center.
Department of General Surgery, The 7th Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong.
Anticancer Drugs. 2022 Jan 1;33(1):e741-e746. doi: 10.1097/CAD.0000000000001163.
Most hepatocellular carcinoma (HCC) patients have dismal prognoses because they are already in the advanced stage at the time of initial diagnosis and are unable to undergo upfront surgery. Recent studies of immune checkpoint inhibitors (ICIs) and antiangiogenic agents (AAAs) have shown encouraging results for unresectable HCC (uHCC). Here, we report a patient with uHCC who was treated with a combination of anlotinib and sintilimab (sintilimab 200 mg, intravenous glucose tolerance test, q21d and anlotinib 12 mg, orally, d1-14, q21d), an analog of the combination of lenvatinib and pembrolizumab with much lower cost. The patient with recurrent uHCC was downstaged to resectable disease by the combination therapy. After eight cycles of treatment with anlotinib and sintilimab, the patient underwent a second operation. The histology of the resected mass revealed a major and almost complete pathological response. However, this patient was diagnosed with type I diabetes mellitus with ketoacidosis after nearly 10 cycles of combination treatment with anlotinib and sintilimab. Active follow-ups revealed no signs of local recurrence or distant failure. In conclusion, this case report demonstrated that the combination of anlotinib and sintilimab, one of the strategies combining ICIs with AAAs, showed promising efficacy in the treatment of uHCC patients.
大多数肝细胞癌（HCC）患者预后较差，因为他们在初始诊断时已经处于晚期，无法进行 upfront 手术。最近对免疫检查点抑制剂（ICIs）和抗血管生成药物（AAAs）的研究显示，不可切除 HCC（uHCC）的治疗结果令人鼓舞。在这里，我们报告了一例 uHCC 患者，他接受了安罗替尼和信迪利单抗（信迪利单抗 200mg，静脉葡萄糖耐量试验，q21d 和安罗替尼 12mg，口服，d1-14，q21d）的联合治疗，安罗替尼是仑伐替尼和帕博利珠单抗联合治疗的类似物，成本低得多。联合治疗使复发性 uHCC 患者降期为可切除疾病。接受安罗替尼和信迪利单抗治疗 8 个周期后，患者进行了第二次手术。切除肿块的组织学显示出主要的且几乎完全的病理反应。然而，在接受安罗替尼和信迪利单抗联合治疗近 10 个周期后，该患者被诊断为 1 型糖尿病伴酮症酸中毒。积极的随访显示没有局部复发或远处失败的迹象。总之，该病例报告表明，安罗替尼和信迪利单抗联合治疗，即联合应用 ICIs 和 AAAs 的策略之一，在治疗 uHCC 患者方面显示出了有希望的疗效。
