Biglow Layana, Ashraf Sara, Alsharedi Mohamed
Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Division of Hematology and Oncology, Joan C. Edwards School of Medicine, Marshall University, Edwards Comprehensive Cancer Center at Cabell Huntington Hospital, Huntington, WV, USA.
Stem Cell Investig. 2021 Nov 10;8:22. doi: 10.21037/sci-2021-029. eCollection 2021.
To systematically review the ongoing progress of effective treatment of advanced hepatocellular carcinoma (HCC), mainly focusing on immune checkpoint inhibitors (ICPI) as monotherapy and combination therapy.
HCC in general has a poor prognosis; particularly in the advanced stage. For more than 10 years, the treatment with multikinase inhibitors was the first line treatment. Before the introduction of checkpoint inhibitors, very few treatments were available for patients with hepatocellular cancer in the advanced stage, especially in metastatic and unresectable disease.
We performed an extensive search of the ongoing and published clinical trials in the English written literature concerning of HCC with immune checkpoint inhibition when compared to first line chemotherapy.
The treatment paradigm for advanced stage HCC has significantly changed recently with the introduction of immunotherapy; based on existing research, there is new era for HCC treatment which will positively affect the outcome in a malignancy that did not see therapy advancement for more than a decade. Monoclonal antibodies against programmed death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1), such as nivolumab and pembrolizumab appear to be a promising therapeutic option in HCC. This review outlines immunotherapy that has been approved, and what inhibitors are under investigation for patients with advanced stage HCC.
系统回顾晚期肝细胞癌（HCC）有效治疗的进展情况，主要聚焦免疫检查点抑制剂（ICPI）作为单药治疗和联合治疗的情况。
总体而言，HCC预后较差；尤其是在晚期。十多年来，多激酶抑制剂治疗一直是一线治疗方法。在检查点抑制剂问世之前，晚期肝细胞癌患者，尤其是转移性和不可切除疾病患者的治疗方法非常有限。
我们广泛检索了英文文献中正在进行和已发表的关于HCC免疫检查点抑制与一线化疗对比的临床试验。
随着免疫疗法的引入，晚期HCC的治疗模式最近发生了显著变化；基于现有研究，HCC治疗进入了一个新时代，这将对一种十多年来治疗无进展的恶性肿瘤的治疗结果产生积极影响。抗程序性死亡配体1（PD-L1）和程序性细胞死亡蛋白1（PD-1）的单克隆抗体，如纳武单抗和帕博利珠单抗，似乎是HCC中有前景的治疗选择。本综述概述了已获批的免疫疗法，以及正在研究用于晚期HCC患者的抑制剂。
