Department of Medicine, Royal Marsden Hospital, London and Surrey, United Kingdom.
Am Soc Clin Oncol Educ Book. 2024 Jan;44:e430028. doi: 10.1200/EDBK_430028.
This review explores the dynamic landscape of hepatocellular carcinoma (HCC) treatment, emphasizing on recent developments across various stages and therapeutic approaches. Although curative strategies such as hepatectomy and thermal ablation are standard for early-stage cases, high relapse rates drive investigations into adjuvant and perioperative treatment. Adjuvant therapies face hurdles, but noteworthy advances include IMbrave050 setting a new standard with atezolizumab/bevacizumab. Locoregional treatments gain significance, especially for multifocal HCC, with the integration of innovative combinations with systemic therapies, showing improved outcomes. In the advanced setting, the evolution from sorafenib as the primary first-line option to new standards, such as atezolizumab/bevacizumab and tremelimumab/durvalumab, to other emerging therapies such as tislelizumab and pembrolizumab with lenvatinib, is explored. Additionally, second-line treatments and insights into the interplay between immunotherapies and antiangiogenic agents, as well as novel combination strategies that add complexity to treatment decisions, are discussed.
这篇综述探讨了肝细胞癌（HCC）治疗的动态领域，强调了各个阶段和治疗方法的最新进展。尽管肝切除术和热消融等治愈策略是早期病例的标准治疗方法，但高复发率促使人们研究辅助和围手术期治疗。辅助治疗面临挑战，但值得注意的进展包括 IMbrave050 研究中阿替利珠单抗联合贝伐珠单抗树立了新的标准。局部区域治疗变得越来越重要，特别是对于多灶性 HCC，与系统治疗的创新联合应用显示出改善的结果。在晚期，索拉非尼作为一线治疗的主要药物发生了演变，出现了新的标准治疗药物，如阿替利珠单抗联合贝伐珠单抗、特瑞普利单抗联合度伐利尤单抗，以及其他新兴药物，如替雷利珠单抗联合仑伐替尼，本文对此进行了探讨。此外，还讨论了二线治疗以及免疫治疗和抗血管生成药物之间的相互作用，以及为治疗决策增加复杂性的新的联合策略。
