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阿帕替尼联合卡瑞利珠单抗转化治疗后不可切除肝细胞癌的切除:一例报告及文献综述

Resection of unresectable hepatocellular carcinoma after conversion therapy with apatinib and camrelizumab: a case report and literature review.

作者信息

Liu Xin-Liang, Li Xiang-Ze, Chu Yi-Fu, Liu Feng, Tian Hu

机构信息

Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.

Department of Gastrointestinal Surgery, Shandong Provincial Third Hospital, Shandong University, Jinan, China.

出版信息

Front Oncol. 2024 Mar 27;14:1280805. doi: 10.3389/fonc.2024.1280805. eCollection 2024.

Abstract

Hepatocellular carcinoma is a rather common malignant tumor. Most patients with hepatocellular carcinoma receive their diagnosis at an advanced stage, at which surgical resection is no longer appropriate. A growing body of research has demonstrated the value of convention therapy for patients with intermediate-stage hepatocellular carcinoma, while specific application protocols and treatment guidelines are not well developed. Emerging clinical researches suggest that a tyrosine kinase inhibitor in combination with an immune checkpoint inhibitor is a reasonable strategy for unresectable hepatocellular carcinoma. However, there are relatively few reports on the efficacy of apatinib and camrelizumab in the treatment of hepatocellular carcinoma. We were able to successfully remove one patient's hepatocellular carcinoma after 8 cycles of conversion therapy with apatinib (250 mg orally every day) and camrelizumab (200 mg intravenously every 2 weeks). The patient continued to receive the same dose of 16 cycles of apatinib and camrelizumab after hepatectomy. By the time of this study, the patient has completed 18 months of follow-up, and no tumor recurrence or metastasis was found in tumor markers and imaging examinations. Apatinib in combination with camrelizumab is an effective therapy for the treatment of advanced hepatocellular carcinoma, and surgical resection after this conversion therapy may provide patients with long-term oncological benefits. However, this requires more samples to validate the conclusion.

摘要

肝细胞癌是一种较为常见的恶性肿瘤。大多数肝细胞癌患者在晚期才得到诊断,此时手术切除已不再合适。越来越多的研究表明了传统疗法对中期肝细胞癌患者的价值,而具体的应用方案和治疗指南尚未完善。新出现的临床研究表明,酪氨酸激酶抑制剂与免疫检查点抑制剂联合使用是不可切除肝细胞癌的合理策略。然而,关于阿帕替尼和卡瑞利珠单抗治疗肝细胞癌疗效的报道相对较少。我们在对一名患者进行了8个周期的阿帕替尼(每日口服250毫克)和卡瑞利珠单抗(每2周静脉注射200毫克)转化治疗后,成功切除了其肝细胞癌。肝切除术后,该患者继续接受相同剂量的阿帕替尼和卡瑞利珠单抗治疗16个周期。到本研究时,该患者已完成18个月的随访,肿瘤标志物和影像学检查均未发现肿瘤复发或转移。阿帕替尼联合卡瑞利珠单抗是治疗晚期肝细胞癌的有效疗法,这种转化治疗后的手术切除可能为患者带来长期的肿瘤学益处。然而,这需要更多样本以验证该结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b37/11004284/9ae7ad055bb7/fonc-14-1280805-g001.jpg

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