PDF(Pubmed)
Abstract：
Systemic therapy for hepatocellular carcinoma (HCC) has undergone substantial advancements. With the advent of atezolizumab plus bevacizumab (ATZ/BEV) combination therapy, followed by durvalumab plus tremelimumab, the era of immunotherapy for HCC has commenced. The emergence of systemic treatment with high response rates has led to improvements in overall survival while enabling conversion to radical surgical resection in some patients with HCC. In patients with intermediate-stage HCC, new treatment strategies combining systemic treatment and transcatheter arterial chemoembolization (TACE) are under development in clinical trials. Moreover, the addition of local therapies, such as TACE, to systemic treatment according to the treatment effect could achieve a certain percentage of complete response. In the IMbrave050 trial, the efficacy of ATZ/BEV combination therapy was validated in patients predicted to have a high risk of recurrence, especially in those who had undergone radical surgery or radiofrequency ablation for HCC. Therefore, systemic treatment for HCC is entering a new phase for all disease stages. The objective of this review is to organize the current position of systemic therapy for each HCC stage and discuss the development of new treatment methods and strategies, with a focus on regimens incorporating immune checkpoint inhibitors, along with future prospects.
摘要：
肝细胞癌（HCC）的系统治疗已取得重大进展。随着阿替珠单抗联合贝伐单抗（ATZ/BEV）联合治疗的出现，其次是durvalumab+tremelimumab，肝癌免疫治疗的时代已经开始。具有高反应率的全身性治疗的出现导致总体生存率的改善，同时使一些HCC患者能够转换为根治性手术切除。在中期肝癌患者中，在临床试验中,正在开发结合全身治疗和经导管动脉化疗栓塞(TACE)的新治疗策略.此外，增加局部疗法，比如TACE，根据治疗效果进行全身治疗可以达到一定比例的完全缓解。在IMbrave050试验中,ATZ/BEV联合治疗的疗效在预测复发风险高的患者中得到验证，尤其是那些接受了根治性手术或射频消融治疗HCC的患者。因此,HCC的全身治疗正在进入所有疾病阶段的新阶段。本综述的目的是组织系统治疗的每个阶段肝癌的当前位置，并讨论新的治疗方法和策略的发展，重点是结合免疫检查点抑制剂的方案，以及未来的前景。
