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病例报告:立体定向体部放疗联合PD-1抑制剂治疗难治性转移性肝细胞癌患者的远隔效应

Case Report: Abscopal effect in a patient with refractory metastatic hepatocellular carcinoma treated with stereotactic body radiotherapy and PD-1 inhibitor.

作者信息

Shu Pei, Wang Fang, Wang Xin

机构信息

Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.

Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Immunol. 2025 May 2;16:1536689. doi: 10.3389/fimmu.2025.1536689. eCollection 2025.


DOI:10.3389/fimmu.2025.1536689
PMID:40386774
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12081416/
Abstract

There is currently no established standard treatment for patients with metastatic hepatocellular carcinoma after resistance to tyrosine kinase inhibitors. Given that radiotherapy can reprogram the tumor microenvironment and convert "cold" tumors into "hot" tumors, combining radiotherapy with immunotherapy shows significant potential. In this case, we present a male patient with HBV-related metastatic hepatocellular carcinoma (HCC) accompanied by portal vein tumor thrombosis. The patient achieved abscopal effect with a progression-free survival of 10 months and an overall survival of 21 months with the combination of anti-PD-1 therapy and stereotactic body radiotherapy (SBRT) as third-line treatment. This combination therapy demonstrates relative efficacy and favorability in treating HBV-related advanced HCC.

摘要

目前,对于对酪氨酸激酶抑制剂耐药的转移性肝细胞癌患者,尚无既定的标准治疗方法。鉴于放射治疗可重新编程肿瘤微环境并将“冷”肿瘤转化为“热”肿瘤,放射治疗与免疫治疗联合显示出巨大潜力。在此病例中,我们报告一名患有乙肝病毒相关转移性肝细胞癌(HCC)并伴有门静脉肿瘤血栓形成的男性患者。该患者接受抗程序性死亡蛋白1(PD-1)治疗与立体定向体部放疗(SBRT)联合作为三线治疗,实现了远隔效应,无进展生存期为10个月,总生存期为21个月。这种联合治疗在治疗乙肝病毒相关晚期HCC方面显示出相对疗效和优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2a/12081416/fd459491b989/fimmu-16-1536689-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2a/12081416/fd459491b989/fimmu-16-1536689-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2a/12081416/fd459491b989/fimmu-16-1536689-g001.jpg

相似文献

[1]
Case Report: Abscopal effect in a patient with refractory metastatic hepatocellular carcinoma treated with stereotactic body radiotherapy and PD-1 inhibitor.

Front Immunol. 2025-5-2

[2]
Abscopal effect in a patient with advanced hepatocellular carcinoma upon resuming bevacizumab in combination with atezolizumab after radiotherapy.

Clin J Gastroenterol. 2024-12

[3]
Strategies to Improve the Antitumor Effect of Immunotherapy for Hepatocellular Carcinoma.

Front Immunol. 2021

[4]
Antiangiogenic Treatment Facilitates the Abscopal Effect of Radiation Therapy Combined With Anti-PD-1 in Hepatocellular Carcinoma.

Int J Radiat Oncol Biol Phys. 2025-2-1

[5]
Stereotactic Body Radiotherapy Combined With Lenvatinib With or Without PD-1 Inhibitors as Initial Treatment for Unresectable Hepatocellular Carcinoma.

Int J Radiat Oncol Biol Phys. 2024-12-1

[6]
Anti-PD-1/PD-L1 Blockade Immunotherapy Employed in Treating Hepatitis B Virus Infection-Related Advanced Hepatocellular Carcinoma: A Literature Review.

Front Immunol. 2020

[7]
Stereotactic body radiotherapy in combination with non-frontline PD-1 inhibitors and targeted agents in metastatic renal cell carcinoma.

Radiat Oncol. 2021-11-2

[8]
Recent developments with immunotherapy for hepatocellular carcinoma.

Expert Opin Biol Ther. 2018-7-20

[9]
A study on combination of non-ablative local RFA with PD-1 and angiogenesis blocking to prolong survival through improvement of immune microenvironment in advanced Hepatocellular Carcinoma.

Int Immunopharmacol. 2024-6-15

[10]
Stereotactic body radiotherapy based treatment for hepatocellular carcinoma with extensive portal vein tumor thrombosis.

Radiat Oncol. 2018-9-25

本文引用的文献

[1]
Hepatocellular Carcinoma Showing Tumor Shrinkage Due to an Abscopal Effect.

Intern Med. 2024-1-15

[2]
Combining immunotherapy and radiotherapy in hepatocellular carcinoma: the importance of irradiated tumor burden and the possible role of a low dose radiotherapy induction strategy.

Transl Cancer Res. 2023-4-28

[3]
Radiation therapy in the era of immune treatment for hepatocellular carcinoma.

Front Immunol. 2023

[4]
Pembrolizumab Versus Placebo as Second-Line Therapy in Patients From Asia With Advanced Hepatocellular Carcinoma: A Randomized, Double-Blind, Phase III Trial.

J Clin Oncol. 2023-3-1

[5]
Hepatocellular carcinoma.

Lancet. 2022-10-15

[6]
Combining stereotactic body radiotherapy with camrelizumab for unresectable hepatocellular carcinoma: a single-arm trial.

Hepatol Int. 2022-10

[7]
Radiotherapy combined with immunotherapy: the dawn of cancer treatment.

Signal Transduct Target Ther. 2022-7-29

[8]
Regorafenib Combined with PD-1 Blockade Immunotherapy versus Regorafenib as Second-Line Treatment for Advanced Hepatocellular Carcinoma: A Multicenter Retrospective Study.

J Hepatocell Carcinoma. 2022-3-10

[9]
Combined Stereotactic Body Radiotherapy and Immunotherapy Versus Transarterial Chemoembolization in Locally Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis.

Front Oncol. 2021-12-7

[10]
Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma.

J Hepatol. 2022-4

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