Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
Int J Clin Oncol. 2022 Jul;27(7):1110-1119. doi: 10.1007/s10147-022-02166-0. Epub 2022 May 8.
Since the approval of sorafenib for the treatment of unresectable hepatocellular carcinoma in 2007 (in 2009 in Japan), five more regimens have been approved: lenvatinib, and atezolizumab plus bevacizumab for first-line treatment, and regorafenib, cabozantinib, and ramucirumab for second-line treatment, which are currently available for clinical use. The positive results of durvalumab, a programmed cell death ligand 1 antibody, plus tremelimumab, an anti-cytotoxic T-lymphocyte-associated protein 4 antibody, were also presented at the 2022 American Society Clinical Oncology Gastrointestinal Cancers Symposium as superior to sorafenib in prolonging the overall survival; this combination is expected to be approved by the end of 2022. These systemic therapies are changing the treatment paradigm not only for advanced hepatocellular carcinoma but also for intermediate-stage hepatocellular carcinoma. This review focuses on the role of systemic therapy in intermediate-stage hepatocellular carcinoma.
自 2007 年索拉非尼（2009 年在日本）获批用于不可切除肝细胞癌的治疗以来，又有五种方案获批：仑伐替尼、阿替利珠单抗联合贝伐珠单抗用于一线治疗，regorafenib、卡博替尼和雷莫芦单抗用于二线治疗，目前均已在临床上应用。在 2022 年美国临床肿瘤学会胃肠道癌症研讨会上，程序性死亡配体 1 抗体 durvalumab 联合细胞毒性 T 淋巴细胞相关蛋白 4 抗体 tremelimumab 的积极结果也显示，与索拉非尼相比，该组合在延长总生存期方面具有优势；预计该组合将于 2022 年底获得批准。这些系统疗法不仅改变了晚期肝细胞癌的治疗模式，也改变了中期肝细胞癌的治疗模式。本综述重点介绍了系统治疗在中期肝细胞癌中的作用。
