Xia Y X, Cao H S, Tang W W, Wang X H
Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation,Nanjing Medical University,Nanjing 210000,China.
Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):7-12. doi: 10.3760/cma.j.cn112139-20220819-00361.
With the development of modern liver surgical techniques and the progress of perioperative management,the survival rate after resection of hepatocellular carcinoma has been greatly improved,but the high recurrence and metastasis rate still limits the long-term survival after surgery. Preoperative neoadjuvant therapy has been confirmed to significantly reduce the postoperative recurrence rate and prolong survival in other types of cancer,but there has been a lack of effective systemic therapy for hepatocellular carcinoma for a long time,so the efficacy and regimen of neoadjuvant therapy for hepatocellular carcinoma are still controversial. PD-1/PD-L1 monoclonal antibody combined with anti-angiogenic targeted drugs has become a first-line regimen in systemic therapy for advanced hepatocellular carcinoma. This regimen has definite efficacy and high safety,bringing hope for neoadjuvant therapy of hepatocellular carcinoma. Recently,three clinical trials of neoadjuvant immunotherapy for hepatocellular carcinoma have been published internationally,which preliminarily suggest the efficacy and safety of neoadjuvant immunotherapy for hepatocellular carcinoma and lay a solid foundation for carrying out larger sample clinical studies in the future.
随着现代肝脏外科技术的发展以及围手术期管理的进步，肝细胞癌切除术后的生存率有了显著提高，但高复发转移率仍限制着术后的长期生存。术前新辅助治疗已被证实能显著降低其他类型癌症的术后复发率并延长生存期，但长期以来肝细胞癌缺乏有效的全身治疗方法，因此肝细胞癌新辅助治疗的疗效及方案仍存在争议。PD-1/PD-L1单克隆抗体联合抗血管生成靶向药物已成为晚期肝细胞癌全身治疗的一线方案。该方案疗效确切且安全性高，为肝细胞癌新辅助治疗带来了希望。近期，国际上发表了三项肝细胞癌新辅助免疫治疗的临床试验，初步提示了肝细胞癌新辅助免疫治疗的疗效及安全性，为未来开展更大样本量的临床研究奠定了坚实基础。
