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最大化肝细胞癌的治疗效果:联合治疗策略的见解

Maximizing therapeutic outcomes in hepatocellular carcinoma: Insights into combinatorial strategies.

作者信息

Ilhan Yusuf, Ergun Yakup

机构信息

Department of Medical Oncology, Antalya City Hospital, Antalya 07080, Türkiye.

出版信息

World J Gastrointest Oncol. 2024 Jul 15;16(7):2888-2893. doi: 10.4251/wjgo.v16.i7.2888.

Abstract

In this editorial, we review the article by Ma and colleagues, published in the . Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality. Although transarterial chemoembolization (TACE) has been used effectively for several years, particularly in patients with intermediate-stage HCC, the quest for the optimal combination therapy to enhance its efficacy and HCC treatment strategies persists. Combining TACE with tyrosine kinase inhibitors (TKIs) like sorafenib or lenvatinib has shown confusing results in improving both progression-free survival and overall survival. Similarly, combining TACE with immune checkpoint inhibitors (ICIs) has demonstrated potential efficacy by reshaping the tumor microenvironment and activating immune responses. Recent studies suggest combining TACE with TKIs and ICIs may offer synergistic effects. Additionally, combining TKIs and ICIs with other local treatments like microwave ablation or hepatic arterial infusion chemotherapy has shown promise in enhancing efficacy. However, more extensive prospective studies are needed to validate these findings. Overall, these combinations represent a promising direction in HCC management, emphasizing the need for further research to optimize treatment outcomes.

摘要

在这篇社论中,我们回顾了马及其同事发表在《 》上的文章。肝细胞癌(HCC)是癌症相关死亡的主要原因。尽管经动脉化疗栓塞术(TACE)已经有效应用了数年,尤其是在中期HCC患者中,但寻求提高其疗效的最佳联合治疗方法以及HCC治疗策略的探索仍在继续。将TACE与索拉非尼或仑伐替尼等酪氨酸激酶抑制剂(TKIs)联合使用,在改善无进展生存期和总生存期方面显示出令人困惑的结果。同样,将TACE与免疫检查点抑制剂(ICIs)联合使用,已通过重塑肿瘤微环境和激活免疫反应证明了潜在疗效。最近的研究表明,将TACE与TKIs和ICIs联合使用可能会产生协同效应。此外,将TKIs和ICIs与微波消融或肝动脉灌注化疗等其他局部治疗方法联合使用,在提高疗效方面已显示出前景。然而,需要更广泛的前瞻性研究来验证这些发现。总体而言,这些联合治疗方法代表了HCC治疗管理中一个有前景的方向,强调需要进一步研究以优化治疗效果。

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