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一名肝细胞癌患者在接受初次根治性治疗后接受免疫检查点抑制剂治疗,之后进行免疫治疗再治疗:病例报告

Retreatment with immunotherapy in a patient with hepatocellular carcinoma who received immune checkpoint inhibitors after primary curative treatment: a case report.

作者信息

Wang Tao, Tang Fei, Li Fenghui, Yin Weili, Liang Jing

机构信息

Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin, China.

出版信息

Front Oncol. 2024 Apr 5;14:1321195. doi: 10.3389/fonc.2024.1321195. eCollection 2024.

Abstract

Hepatocellular carcinoma (HCC) presents a malignant pathology known for its high early recurrence rate following curative treatment, significantly impacting patient prognosis. Currently, effective strategies to mitigate early HCC recurrence remain undetermined. In this report, we document a case of HCC managed with curative radiofrequency ablation (RFA), particularly in a patient facing a high risk of early recurrence due to a substantial tumor size. In an effort to forestall recurrence, immune checkpoint inhibitors (ICIs) were preemptively administered for 6 months post-RFA. Despite this, early recurrence ensued upon ICIs cessation. Traditionally, the approach to advanced HCC has been conservative, yet recent years have seen promising outcomes with ICIs in advanced HCC. However, research on ICIs retreatment is limited. In the short term, this patient experienced widespread metastases post-ICIs discontinuation, yet exhibited prompt regression upon ICIs reinitiation. Notably, this represents the initial documented instance of employing ICIs to forestall recurrence subsequent to curative RFA in HCC. Following ICIs discontinuation, diffuse recurrence with multiple metastases emerged, with successful resolution upon ICIs retreatment.

摘要

肝细胞癌(HCC)是一种恶性病理疾病,以其在根治性治疗后早期复发率高而闻名,这对患者的预后有重大影响。目前,减轻早期HCC复发的有效策略仍未确定。在本报告中,我们记录了一例通过根治性射频消融(RFA)治疗的HCC病例,特别是在一名因肿瘤体积较大而面临早期复发高风险的患者中。为了预防复发,在RFA后预先给予免疫检查点抑制剂(ICI)6个月。尽管如此,在ICI停药后仍发生了早期复发。传统上,晚期HCC的治疗方法一直比较保守,但近年来ICI在晚期HCC中取得了令人鼓舞的结果。然而,关于ICI再治疗的研究有限。短期内,该患者在ICI停药后出现广泛转移,但在重新开始使用ICI后迅速消退。值得注意的是,这是首次记录的在HCC根治性RFA后使用ICI预防复发的病例。在ICI停药后,出现了伴有多处转移的弥漫性复发,再次使用ICI后成功缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6768/11026608/cbf187c2d566/fonc-14-1321195-g001.jpg

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