PDF(Pubmed)
Abstract：
The combination regimen of atezolizumab plus bevacizumab (Atezo/Bev) is currently used as first-line treatment in patients with unresectable hepatocellular carcinoma. Herein, we report a rare case of curative hepatic resection performed as conversion surgery in a patient with intermediate-stage hepatocellular carcinoma following preoperative Atezo/Bev therapy. After five treatment cycles of Atezo/Bev therapy, followed by four cycles of atezolizumab monotherapy, the tumor marker levels decreased to baseline levels and 22 small daughter nodules disappeared, leaving only the primary tumor. Therefore, we performed resection of the primary tumor as conversion surgery, and postoperative histopathology confirmed complete tumor necrosis. No cancer recurrence has been observed until the 5-month postoperative follow-up, and the patient remains drug free. Consistent with the findings in this case, a review of previously reported cases revealed that in cases of successful conversion surgery, neoadjuvant Atezo/Bev therapy was associated with intra-tumoral bleeding, immune-related adverse events, and normalization of the tumor marker levels.
摘要：
阿特珠单抗加贝伐单抗（Atezo/Bev）的组合方案目前被用作不可切除的肝细胞癌患者的一线治疗。在这里，我们报道了1例中晚期肝细胞癌患者在术前接受Atezo/Bev治疗后作为转化手术进行治愈性肝切除的罕见病例.经过五个治疗周期的Atezo/Bev治疗，随后是四个周期的阿替珠单抗单药治疗，肿瘤标志物水平下降到基线水平，22个小子结节消失，只留下原发肿瘤.因此,我们将原发肿瘤切除作为转换手术，术后组织病理学证实肿瘤完全坏死。直到术后5个月随访，才观察到癌症复发。病人仍然没有药物。与本案的调查结果一致，对先前报道的病例的回顾显示，在成功转换手术的情况下，Atezo/Bev新辅助治疗与肿瘤内出血相关，免疫相关不良事件，和肿瘤标志物水平的正常化。
