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肝细胞癌(HCC)全身治疗的最新进展

Recent Progress in Systemic Therapy for Hepatocellular Cancer (HCC).

作者信息

Ghaziani T Tara, Dhanasekaran Renumathy

机构信息

Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA.

出版信息

Curr Treat Options Gastroenterol. 2021 Jun;19(2):351-368. doi: 10.1007/s11938-021-00346-x. Epub 2021 Mar 31.

Abstract

PURPOSE OF REVIEW

The management of advanced hepatocellular (HCC) has drastically changed in the past few years with approval of several first line and second line systemic therapies. In this review we present an overview of the recent progress in the treatment of advanced HCC and discuss future perspectives.

RECENT FINDINGS

The phase 3 clinical trial IMBRAVE150 has recently shown the combination of an immune checkpoint inhibitor, atezolizumab, with an anti-angiogenic agent, bevacizumab, to be superior to sorafenib monotherapy for treatment-naive advanced HCC. Moreover, patients now have multiple options available in second-line therapy including targeted therapies like sorafenib, lenvatinib, regorafenib, cabozantinib, ramucirumab and immunotherapies like atezolizumab, and nivolumab either alone or combined with ipilimumab.

SUMMARY

There has been tremendous recent progress in the management of advanced HCC. Combination therapy with atezolizumab-bevacizumab has recently become the standard first line of therapy for patients with advanced HCC. Additionally, immunotherapy agents are poised to play a significant role in the management of HCC either alone or in combination with molecular targeted therapies.

摘要

综述目的

在过去几年中,随着多种一线和二线全身治疗药物的获批,晚期肝细胞癌(HCC)的管理发生了巨大变化。在本综述中,我们概述了晚期HCC治疗的最新进展,并讨论未来前景。

最新发现

3期临床试验IMBRAVE150最近显示,免疫检查点抑制剂阿替利珠单抗与抗血管生成药物贝伐珠单抗联合使用,对于初治的晚期HCC患者,优于索拉非尼单药治疗。此外,患者在二线治疗中有多种选择,包括索拉非尼、仑伐替尼、瑞戈非尼、卡博替尼、雷莫西尤单抗等靶向治疗,以及阿替利珠单抗、纳武利尤单抗等免疫治疗,后者可单独使用或与伊匹木单抗联合使用。

总结

最近晚期HCC的管理取得了巨大进展。阿替利珠单抗-贝伐珠单抗联合治疗最近已成为晚期HCC患者的标准一线治疗方法。此外,免疫治疗药物无论是单独使用还是与分子靶向治疗联合使用,都有望在HCC的管理中发挥重要作用。

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