Li Shan, Zhou Zhen-Feng, Long Hao-Jian, Yin Jia-Xin, Wang Hui-Zhong, Zhao Jian-Fu
Research Center of Cancer Diagnosis and Therapy, Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Transl Gastroenterol Hepatol. 2025 Jan 17;10:17. doi: 10.21037/tgh-24-91. eCollection 2025.
Hepatocellular carcinoma (HCC) is a highly malignant tumor of the digestive system with a poor prognosis. Huge HCC, a subtype characterized by tumors measuring at least 10 cm in diameter, often presents with macrovascular invasion, satellite nodules, metastases, and other aggressive characteristics, posing significant challenges for treatment. The era of combined targeted therapy and immunotherapy has brought new hope to patients with advanced HCC. The development of innovative combination medication regimens for HCC is a current area of intense clinical research interest. We are trying to explore new combination therapies based on target-immunity combination therapy in the hope of better-benefiting patients with advanced huge HCC.
We present a patient with Barcelona Clinical Liver Cancer Stage C huge HCC who was treated with combined targeted therapy and immunotherapy as the primary therapeutic regimen, supplemented with tegafur long-term metronomic chemotherapy, as well as specialized adjuvant therapy such as thymosin, bisphosphonates, antiviral medication, and vitamin C supplementation. The tumor size was significantly reduced and microwave ablation was performed, after which, the patient was kept on the combination regimen, resulting in a partial response (PR), and maintaining PR without disease progression for 32 months.
The combination regimen may enhance advanced huge HCC treatment and provide a new multimodal drug strategy for HCC.
肝细胞癌(HCC)是一种预后较差的高恶性消化系统肿瘤。巨大HCC是一种亚型,其特征为肿瘤直径至少10厘米,常伴有大血管侵犯、卫星结节、转移及其他侵袭性特征,给治疗带来重大挑战。靶向治疗与免疫治疗联合的时代为晚期HCC患者带来了新希望。开发用于HCC的创新联合用药方案是当前临床研究的一个热点领域。我们试图探索基于靶向 - 免疫联合治疗的新联合疗法,以期让晚期巨大HCC患者更多受益。
我们报告一例巴塞罗那临床肝癌C期巨大HCC患者,其接受以靶向治疗与免疫治疗联合作为主要治疗方案,并辅以替加氟长期小剂量化疗,以及诸如胸腺肽、双膦酸盐、抗病毒药物和补充维生素C等特殊辅助治疗。肿瘤大小显著缩小并进行了微波消融,之后患者继续接受联合方案治疗,获得部分缓解(PR),并在无疾病进展的情况下维持PR达32个月。
该联合方案可能增强晚期巨大HCC的治疗效果,并为HCC提供一种新的多模式药物策略。