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病例报告:抗血管生成治疗联合免疫检查点抑制剂与肿瘤内冷冻消融治疗肝细胞癌。

Case Report: Antiangiogenic Therapy Plus Immune Checkpoint Inhibitors Combined With Intratumoral Cryoablation for Hepatocellular Carcinoma.

机构信息

Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China.

Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China.

出版信息

Front Immunol. 2021 Oct 18;12:740790. doi: 10.3389/fimmu.2021.740790. eCollection 2021.

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is a common gastrointestinal malignancy with high incidence and poor prognosis. Common treatment methods include surgery, transcatheter arterial chemoembolization (TACE), ablation, and targeted therapy. In recent years, combination treatment with antiangiogenic therapy and immune checkpoint inhibitors has made great progress in the treatment of advanced HCC. Here, we report the case of a patient with HCC who achieved a durable benefit from anti-vascular therapy and immune checkpoint inhibitors combined with intratumoral cryoablation.

MAIN BODY

A 38-year-old male patient initially presented with severe abdominal pain that was identified as an HCC rupture and hemorrhage by computed tomography (CT). The patient underwent emergency surgery and postoperative pathology confirmed HCC. The patient received prophylactic TACE after surgery. Unfortunately, three months after surgery, the patient developed multiple liver metastases. Subsequently, he received systemic anti-vascular therapy and immune checkpoint inhibitors combined with intratumoral cryoablation. After treatment, the patient achieved extensive tumor necrosis and the disease was effectively controlled.

CONCLUSIONS

Anti-angiogenic therapy and immune checkpoint inhibitors combined with cryoablation can induce a powerful and effective systemic anti-tumor immune response, which is worthy of further research.

摘要

背景

肝细胞癌(HCC)是一种常见的胃肠道恶性肿瘤,发病率高,预后差。常见的治疗方法包括手术、经导管动脉化疗栓塞(TACE)、消融和靶向治疗。近年来,抗血管生成治疗与免疫检查点抑制剂联合治疗在晚期 HCC 的治疗中取得了重大进展。在此,我们报告了一例 HCC 患者,他通过抗血管治疗和免疫检查点抑制剂联合肿瘤内冷冻消融治疗获得了持久的获益。

主要内容

一名 38 岁男性患者最初因严重腹痛就诊,经计算机断层扫描(CT)诊断为 HCC 破裂出血。患者接受了紧急手术,术后病理证实为 HCC。手术后患者接受了预防性 TACE。不幸的是,手术后三个月,患者出现多处肝转移。随后,他接受了全身抗血管治疗和免疫检查点抑制剂联合肿瘤内冷冻消融治疗。治疗后,患者广泛的肿瘤坏死,疾病得到有效控制。

结论

抗血管生成治疗与免疫检查点抑制剂联合冷冻消融治疗可诱导强大而有效的全身抗肿瘤免疫反应,值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fa5/8559549/e65da739fc83/fimmu-12-740790-g001.jpg

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