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基于免疫检查点抑制剂与抗血管生成靶向药物联合的晚期肝细胞癌转化治疗后序贯手术中国专家共识(2024年版)

Chinese expert consensus on sequential surgery following conversion therapy based on combination of immune checkpoint inhibitors and antiangiogenic targeted drugs for advanced hepatocellular carcinoma (2024 edition).

作者信息

Tang Haowen, Zhang Wenwen, Cao Junning, Cao Yinbiao, Bi Xinyu, Zhao Haitao, Zhang Ze, Liu Zhe, Wan Tao, Lang Ren, Sun Wenbing, Du Shunda, Yang Yongping, Lu Yinying, Zeng Daobing, Wu Jushan, Duan Binwei, Lin Dongdong, Li Fei, Meng Qinghua, Zhou Jun, Xing Baocai, Tian Xiaodong, Zhu Jiye, Gao Jie, Hao Chunyi, Wang Zhiqiang, Duan Feng, Wang Zhijun, Wang Maoqiang, Liang Bin, Chen Yongwei, Xu Yinzhe, Li Kai, Li Chengang, Hu Minggen, Wang Zhaohai, Cai Shouwang, Ji Wenbin, Xia Nianxin, Zheng Wenheng, Wang Hongguang, Li Gong, Zhu Ziman, Huang Zhiyong, Zhang Wanguang, Tao Kaishan, Liang Jun, Zhang Keming, Dai Chaoliu, Li Jiangtao, Qiu Qiu, Guo Yuan, Wu Liqun, Ding Weibao, Zhu Zhenyu, Gu Wanqing, Cao Jingyu, Wang Zusen, Tian Lantian, Ding Huiguo, Li Guangming, Zeng Yongyi, Wang Kui, Yang Ning, Jin Haosheng, Chen Yajin, Yang Yinmo, Xiu Dianrong, Yan Maolin, Wang Xiaodong, Han Quanli, Jiao Shunchang, Tan Guang, Wang Jizhou, Liu Lianxin, Song Jinghai, Liao Jiajie, Zhao Hong, Li Peng, Song Tianqiang, Wang Zhanbo, Yuan Jing, Hu Bingyang, Yuan Yufeng, Zhang Meng, Sun Shuyang, Zhang Jialin, Wang Wentao, Wen Tianfu, Yang Jiayin, Du Xilin, Peng Tao, Xia Feng, Liu Zuojin, Niu Weibo, Liang Ping, Xu Jianming, Zhao Xiao, Zhu Min, Wang Huaizhi, Kuang Ming, Shen Shunli, Cui Xing, Zhou Jinxue, Liu Rong, Sun Huichuan, Fan Jia, Chen Xiaoping, Zhou Jian, Cai Jianqiang, Lu Shichun

机构信息

Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center of the Chinese PLA General Hospital, Institute of Hepatobiliary Surgery of the Chinese PLA, Beijing, China.

Organ Transplantation Center, the Affiliated Hospital of Qingdao University, Shandong, China.

出版信息

Biosci Trends. 2025 Jan 14;18(6):505-524. doi: 10.5582/bst.2024.01394. Epub 2024 Dec 25.

Abstract

Up to half of hepatocellular carcinoma (HCC) cases are diagnosed at an advanced stage, for which effective treatment options are lacking, resulting in a poor prognosis. Over the past few years, the combination of immune checkpoint inhibitors and anti-angiogenic targeted therapy has proven highly efficacious in treating advanced HCC, significantly extending patients' survival and providing a potential for sequential curative surgery. After sequential curative hepatectomy or liver transplantation following conversion therapy, patients can receive long-term survival benefits. In order to improve the long-term survival rate of the overall population with liver cancer and achieve the goal of a 15% increase in the overall 5-year survival rate outlined in the Healthy China 2030 blueprint, the Professional Committee for Prevention and Control of Hepatobiliary and Pancreatic Diseases of Chinese Preventive Medicine Association, Chinese Society of Liver Cancer, and the Liver Study Group of Surgery Committee of Beijing Medical Association organized in-depth discussions among relevant domestic experts in the field. These discussions focused on the latest progress since the release of the Chinese expert consensus on conversion therapy of immune checkpoint inhibitors combined antiangiogenic targeted drugs for advanced hepatocellular carcinoma (2021 Edition) and resulted in a new consensus on the modifications and supplements to related key points. This consensus aims to further guide clinical practice, standardize medical care, and promote the development of the discipline.

摘要

高达一半的肝细胞癌(HCC)病例在晚期被诊断出来,而针对晚期病例缺乏有效的治疗选择,导致预后不良。在过去几年中,免疫检查点抑制剂和抗血管生成靶向治疗的联合已被证明在治疗晚期HCC方面非常有效,显著延长了患者的生存期,并为序贯根治性手术提供了可能。在转化治疗后进行序贯根治性肝切除术或肝移植后,患者可获得长期生存益处。为提高肝癌总体人群的长期生存率,实现《健康中国2030》规划纲要提出的总体5年生存率提高15%的目标,中国预防医学会肝胆胰疾病预防与控制专业委员会、中国肝癌学会以及北京医学会外科学分会肝脏学组组织国内该领域相关专家进行了深入讨论。这些讨论聚焦于《中国肝细胞癌免疫检查点抑制剂联合抗血管生成靶向药物转化治疗专家共识(2021年版)》发布以来的最新进展,并就相关关键点的修改和补充达成了新的共识。本共识旨在进一步指导临床实践、规范医疗行为并推动学科发展。

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