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肝细胞癌的治疗景观。

The therapeutic landscape of hepatocellular carcinoma.

机构信息

Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.

出版信息

Med. 2021 May 14;2(5):505-552. doi: 10.1016/j.medj.2021.03.002. Epub 2021 Apr 27.

Abstract

The liver is endowed with an amazing regenerative capacity that allows it to withstand an enormous amount of damage. Nevertheless, it is precisely this highly regenerative capacity that renders it susceptible to dysplasia and liver cancer. Liver cancer is not only one of the most common cancers but also one of the deadliest. Hepatocellular carcinoma (HCC) is the most common form of liver cancer, accounting for up to 70%-90% of all cases, but treatment options for advanced stages remain scarce. Therefore, a great deal of effort has gone into identifying early diagnostic markers as well as novel therapies, both local and systemic, for the treatment of this deadly disease. In this review, we aim to shed light into the current therapeutic landscape of HCC with an emphasis on the available treatments, ranging from surgical and local-ablative therapy for early and intermediate stages of the disease to systemic therapies for advanced cancer treatments. We will also address the molecular mechanisms and limitations of currently available systemic therapies and the causes of treatment resistance and finally summarize the emerging future avenues and novel concepts that are promising.

摘要

肝脏具有惊人的再生能力,能够承受大量的损伤。然而,正是这种高度的再生能力使其容易发生发育异常和肝癌。肝癌不仅是最常见的癌症之一,也是最致命的癌症之一。肝细胞癌 (HCC) 是最常见的肝癌形式,占所有病例的 70%-90%,但晚期治疗选择仍然稀缺。因此,人们一直在努力寻找早期诊断标志物以及新的治疗方法,包括局部和全身治疗,以治疗这种致命疾病。在这篇综述中,我们旨在阐明 HCC 的当前治疗现状,重点介绍从疾病早期和中期的手术和局部消融治疗到晚期癌症的全身治疗等各种现有治疗方法。我们还将讨论当前全身治疗方法的分子机制和局限性以及治疗耐药性的原因,并最终总结有前途的新兴未来途径和新观念。

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