Moriguchi Michihisa, Kataoka Seita, Itoh Yoshito
Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-0841, Japan.
Cancers (Basel). 2024 Jun 28;16(13):2387. doi: 10.3390/cancers16132387.
Systemic therapy for hepatocellular carcinoma (HCC) has undergone substantial advancements. With the advent of atezolizumab plus bevacizumab (ATZ/BEV) combination therapy, followed by durvalumab plus tremelimumab, the era of immunotherapy for HCC has commenced. The emergence of systemic treatment with high response rates has led to improvements in overall survival while enabling conversion to radical surgical resection in some patients with HCC. In patients with intermediate-stage HCC, new treatment strategies combining systemic treatment and transcatheter arterial chemoembolization (TACE) are under development in clinical trials. Moreover, the addition of local therapies, such as TACE, to systemic treatment according to the treatment effect could achieve a certain percentage of complete response. In the IMbrave050 trial, the efficacy of ATZ/BEV combination therapy was validated in patients predicted to have a high risk of recurrence, especially in those who had undergone radical surgery or radiofrequency ablation for HCC. Therefore, systemic treatment for HCC is entering a new phase for all disease stages. The objective of this review is to organize the current position of systemic therapy for each HCC stage and discuss the development of new treatment methods and strategies, with a focus on regimens incorporating immune checkpoint inhibitors, along with future prospects.
肝细胞癌（HCC）的系统治疗取得了重大进展。随着阿替利珠单抗联合贝伐单抗（ATZ/BEV）联合疗法的出现，随后是度伐利尤单抗联合曲美木单抗，HCC免疫治疗时代已经开启。高缓解率的系统治疗的出现提高了总生存率，同时使一些HCC患者能够转化为根治性手术切除。在中期HCC患者中，将系统治疗与经动脉化疗栓塞术（TACE）相结合的新治疗策略正在临床试验中研发。此外，根据治疗效果在系统治疗中添加TACE等局部治疗可实现一定比例的完全缓解。在IMbrave050试验中，ATZ/BEV联合疗法的疗效在预测有高复发风险的患者中得到验证，尤其是那些接受过HCC根治性手术或射频消融的患者。因此，HCC的系统治疗正在进入针对所有疾病阶段的新阶段。本综述的目的是梳理HCC各阶段系统治疗的现状，讨论新治疗方法和策略的发展，重点是包含免疫检查点抑制剂的方案以及未来前景。
