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成功的多学科治疗,包括阿替利珠单抗联合贝伐单抗生物治疗,用于治疗靠近大血管的多发性肝细胞癌:一例报告

Successful Multidisciplinary Treatment, Including Atezolizumab Plus Bevacizumab Biological Therapy, for Multiple Hepatocellular Carcinomas Adjacent to Major Vessels: A Case Report.

作者信息

Harada Kei, Fujikawa Takahisa, Uemoto Yusuke, Aibe Yuki

机构信息

Surgery, Kokura Memorial Hospital, Kitakyushu, JPN.

Gastroenterology, Kokura Memorial Hospital, Kitakyushu, JPN.

出版信息

Cureus. 2024 Feb 11;16(2):e53997. doi: 10.7759/cureus.53997. eCollection 2024 Feb.

DOI:10.7759/cureus.53997
PMID:38476801
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10928465/
Abstract

Multiple hepatocellular carcinomas (HCCs) are currently being treated with multimodal therapy that includes liver resection and local therapy. Although the necessity of multimodal therapy for multiple HCCs is evident, treating them is extremely difficult due to the complex nature of multiple HCCs and the frequent occurrence of underlying liver damage. We encountered a case in which long-term tumor control was achieved through multidisciplinary treatment, including atezolizumab plus bevacizumab combination biological therapy. As in the current case, less-invasive surgical resection combined with radiofrequency ablation after a combination of biological therapy may be one of the preferred options for the treatment of initially unresectable multiple HCCs.

摘要

目前,多灶性肝细胞癌(HCC)采用包括肝切除和局部治疗在内的多模式疗法进行治疗。尽管多模式疗法对多灶性HCC的必要性显而易见,但由于多灶性HCC的复杂性和潜在肝损伤的频繁发生,治疗极为困难。我们遇到了一例通过多学科治疗实现长期肿瘤控制的病例,包括阿替利珠单抗联合贝伐单抗的生物联合疗法。正如当前病例一样,在生物联合治疗后,采用微创性手术切除联合射频消融可能是治疗初始不可切除的多灶性HCC的首选方案之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/05ddccd9efff/cureus-0016-00000053997-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/5a04383728c9/cureus-0016-00000053997-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/d674e63fe276/cureus-0016-00000053997-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/4a8792ec7818/cureus-0016-00000053997-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/b2ae1dca66b0/cureus-0016-00000053997-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/05ddccd9efff/cureus-0016-00000053997-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/5a04383728c9/cureus-0016-00000053997-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/d674e63fe276/cureus-0016-00000053997-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/4a8792ec7818/cureus-0016-00000053997-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/b2ae1dca66b0/cureus-0016-00000053997-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10928465/05ddccd9efff/cureus-0016-00000053997-i05.jpg

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本文引用的文献

1
Combination of Ablation and Immunotherapy for Hepatocellular Carcinoma: Where We Are and Where to Go.消融联合免疫治疗肝细胞癌:现状与展望。
Front Immunol. 2021 Dec 15;12:792781. doi: 10.3389/fimmu.2021.792781. eCollection 2021.
2
Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma.IMbrave150研究的更新疗效和安全性数据:阿替利珠单抗联合贝伐珠单抗对比索拉非尼治疗不可切除肝细胞癌。
J Hepatol. 2022 Apr;76(4):862-873. doi: 10.1016/j.jhep.2021.11.030. Epub 2021 Dec 11.
3
Atezolizumab plus bevacizumab combination enables an unresectable hepatocellular carcinoma resectable and links immune exclusion and tumor dedifferentiation to acquired resistance.
阿替利珠单抗联合贝伐单抗可使不可切除的肝细胞癌变为可切除,并将免疫排斥和肿瘤去分化与获得性耐药联系起来。
Exp Hematol Oncol. 2021 Aug 16;10(1):45. doi: 10.1186/s40164-021-00237-y.
4
Multimodal therapy for hepatocellular carcinoma: the role of surgery.多模态治疗肝癌:手术的作用。
Eur Rev Med Pharmacol Sci. 2021 Jul;25(13):4470-4477. doi: 10.26355/eurrev_202107_26238.
5
Systemic therapy of advanced hepatocellular carcinoma.晚期肝细胞癌的系统治疗。
Future Oncol. 2021 Apr;17(10):1237-1251. doi: 10.2217/fon-2020-0758. Epub 2020 Dec 14.
6
Long-term outcomes of liver resection for multiple hepatocellular carcinomas: Single-institution experience with 187 patients.多灶性肝细胞癌肝切除的长期疗效:单中心187例患者的经验
Ann Hepatobiliary Pancreat Surg. 2020 Nov 30;24(4):437-444. doi: 10.14701/ahbps.2020.24.4.437.
7
Proton beam radiotherapy vs. radiofrequency ablation for recurrent hepatocellular carcinoma: A randomized phase III trial.质子束放疗与射频消融治疗复发性肝细胞癌的随机 III 期试验。
J Hepatol. 2021 Mar;74(3):603-612. doi: 10.1016/j.jhep.2020.09.026. Epub 2020 Oct 5.
8
Atezolizumab with or without bevacizumab in unresectable hepatocellular carcinoma (GO30140): an open-label, multicentre, phase 1b study.阿替利珠单抗联合或不联合贝伐珠单抗治疗不可切除肝细胞癌(GO30140):一项开放标签、多中心、1b 期研究。
Lancet Oncol. 2020 Jun;21(6):808-820. doi: 10.1016/S1470-2045(20)30156-X.
9
Liver resection transplantation for multiple hepatocellular carcinoma: a propensity score analysis.多灶性肝细胞癌的肝切除与肝移植:一项倾向评分分析
Oncotarget. 2017 Sep 2;8(46):81492-81500. doi: 10.18632/oncotarget.20623. eCollection 2017 Oct 6.
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Hepatic resection provided long-term survival for patients with intermediate and advanced-stage resectable hepatocellular carcinoma.肝切除术为中晚期可切除肝细胞癌患者提供了长期生存。
World J Surg Oncol. 2016 Mar 2;14:62. doi: 10.1186/s12957-016-0811-y.