Arima Shuhei, Kanda Tatsuo, Totsuka Mai, Honda Masayuki, Kanezawa Shini, Sasaki-Tanaka Reina, Matsumoto Naoki, Masuzaki Ryota, Yamagami Hiroaki, Ogawa Masahiro, Kogure Hirofumi
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo 137-8610, Japan.
Med Int (Lond). 2024 Mar 20;4(3):23. doi: 10.3892/mi.2024.147. eCollection 2024 May-Jun.
Hepatocellular carcinoma (HCC) is a common malignancy with a poor prognosis, particularly in patients with advanced-stage disease, elderly individuals and/or in those with poor liver function. Immune checkpoint inhibitor-containing therapies, such as atezolizumab, an anti-programmed death ligand-1 monoclonal antibody, plus bevacizumab, an anti-vascular endothelial growth factor monoclonal antibody, may be effective and safe therapeutic options for elderly patients with advanced-stage HCC. The present study reports the case of a male patient his 80s who consumed alcohol with unresectable advanced-stage HCC who received combination therapy comprising atezolizumab plus bevacizumab for 6 months. The patient achieved a complete response despite the discontinuation of treatment due to nephrotoxicity. It is critical for patients with HCC and a Child-Pugh A grade to continue therapy for HCC, even if they are older. The development of more effective therapies is required for patients with advanced-stage HCC with a worse liver function than those with a Child-Pugh A grade. The case described in the present study demonstrates the need for obtaining further evidence regarding the efficacy and safety of the combination therapy including atezolizumab plus bevacizumab for elderly patients with advanced-stage HCC.
肝细胞癌(HCC)是一种常见的恶性肿瘤,预后较差,尤其是晚期疾病患者、老年人和/或肝功能不佳者。含免疫检查点抑制剂的疗法,如抗程序性死亡配体-1单克隆抗体阿替利珠单抗加抗血管内皮生长因子单克隆抗体贝伐单抗,可能是晚期HCC老年患者有效且安全的治疗选择。本研究报告了一例80多岁的男性患者,他患有不可切除的晚期HCC且有饮酒史,接受了阿替利珠单抗加贝伐单抗的联合治疗6个月。尽管因肾毒性停止治疗,该患者仍实现了完全缓解。对于HCC且Child-Pugh A级的患者,即使年龄较大,继续进行HCC治疗也至关重要。对于肝功能比Child-Pugh A级患者更差的晚期HCC患者,需要开发更有效的疗法。本研究中描述的病例表明,需要获得更多关于阿替利珠单抗加贝伐单抗联合治疗晚期HCC老年患者的疗效和安全性的证据。