Li Tao, Zhao Ying, Li Keren, Li Gong, Li Guangxin
Department of Radiation Oncology, Beijing Tsinghua Changgeng Hospital, Tsinghua University, Beijing, China.
Front Oncol. 2024 Nov 20;14:1461936. doi: 10.3389/fonc.2024.1461936. eCollection 2024.
Hepatocellular carcinoma (HCC) is a highly lethal and invasive cancer. Targeted and immunotherapies are the primary treatment options for unresectable advanced HCC. There are no recognized and consistent systemic follow-up treatments for patients with HCC who experience disease progression after first-line targeted therapies and immune checkpoint inhibitors (ICIs). According to a few studies, lenalidomide is an immunomodulatory drug that has the potential to be an effective treatment for patients who have progressed after treatment with targeted drugs and ICIs.
This article focuses on a patient with HCC whose disease progressed after first-line targeted therapy and ICI therapy combined with lenalidomide as second-line therapy on the basis of the original targeted and ICI regimens, resulting in a favorable oncologic outcome with acceptable toxicity. The progression-free survival (PFS) of the patients in this study reached 3 years, which is much longer than that previously reported, and no progression has occurred thus far.
This case implies that in patients with hepatocellular carcinoma who have failed first-line targeted therapy and ICIs, targeted therapy and ICIs can be restarted with the addition of lenalidomide, with surprising results.
肝细胞癌（HCC）是一种具有高度致死性和侵袭性的癌症。靶向治疗和免疫治疗是不可切除的晚期HCC的主要治疗选择。对于一线靶向治疗和免疫检查点抑制剂（ICI）治疗后出现疾病进展的HCC患者，目前尚无公认且一致的系统性后续治疗方案。根据一些研究，来那度胺是一种免疫调节药物，有可能成为靶向药物和ICI治疗后进展患者的有效治疗方法。
本文重点介绍了一名HCC患者，其在一线靶向治疗和ICI治疗后疾病进展，在此基础上，在原靶向和ICI治疗方案的基础上加用来那度胺作为二线治疗，取得了良好的肿瘤学疗效且毒性可接受。本研究中患者的无进展生存期（PFS）达到了3年，远长于先前报道的时间，且迄今为止未出现进展。
该病例表明，对于一线靶向治疗和ICI治疗失败的肝细胞癌患者，在加用来那度胺的情况下可重新启动靶向治疗和ICI治疗，结果令人惊讶。
