Torres Velasco Marisa, Álvarez Gallego Rafael, Peinado Paloma, Muñoz Gregorio Cesar, Ugidos Lisardo, García Morillo Marcial, Vicente Emilio, Quijano Yolanda, Prados Susana, de la Fuente Enrique, Cubillo Gracián Antonio
HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain.
Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain.
Case Rep Oncol. 2024 Jul 31;17(1):843-851. doi: 10.1159/000539719. eCollection 2024 Jan-Dec.
Hepatocellular carcinoma (HCC) is an aggressive solid tumor associated with high mortality. Surgery is the main treatment consideration for early disease, but patients who present with locally advanced or metastatic HCC at diagnosis have limited treatment options. There has been great progress in locoregional, immunotherapy, and targeted treatments for advanced HCC. Standard of care for HCC has changed due to results demonstrating safety and efficacy in phase 3 studies, namely, for atezolizumab concomitant with bevacizumab. Nonetheless, additional therapeutic approaches are still warranted to further increase overall survival in HCC. A first-in-class treatment option investigated in patients with HCC is Tumor Treating Fields (TTFields) therapy, which is delivered locoregionally to the tumor site from a portable medical device. TTFields are electric fields that interfere with critical cancer cell processes, hindering tumor progression.
Here, we report on a case study of a 62-year-old male patient with HCC receiving TTFields concomitant with sorafenib as second-line therapy. Although the patient experienced adverse events with previous nivolumab, they achieved a complete response and continued on treatment for 51 months until disease progression, which led to treatment cessation. We report that during 39 months of subsequent treatment with TTFields therapy and sorafenib, the patient experienced a good quality of life, low systemic toxicity, and stable disease following a partial response.
These promising findings, along with those of the pilot phase 2 HEPANOVA clinical study, warrant further investigation of TTFields therapy in HCC.
肝细胞癌（HCC）是一种侵袭性实体瘤，死亡率很高。手术是早期疾病的主要治疗选择，但诊断时出现局部晚期或转移性HCC的患者治疗选择有限。晚期HCC的局部区域治疗、免疫治疗和靶向治疗取得了很大进展。由于3期研究结果证明了阿替利珠单抗联合贝伐单抗的安全性和有效性，HCC的护理标准发生了变化。尽管如此，仍需要额外的治疗方法来进一步提高HCC患者的总生存期。在HCC患者中研究的一种一流治疗选择是肿瘤电场（TTFields）疗法，它通过便携式医疗设备局部输送到肿瘤部位。TTFields是干扰关键癌细胞过程、阻碍肿瘤进展的电场。
在此，我们报告一例62岁男性HCC患者接受TTFields联合索拉非尼作为二线治疗的病例研究。尽管该患者先前使用纳武单抗时出现了不良事件，但他们实现了完全缓解，并持续治疗51个月直至疾病进展，导致治疗停止。我们报告，在随后39个月的TTFields疗法和索拉非尼治疗期间，患者经历了良好的生活质量、低全身毒性，且在部分缓解后疾病稳定。
这些有前景的发现，以及2期HEPANOVA临床研究试点阶段的发现，值得对HCC的TTFields疗法进行进一步研究。
