切换至 "中华医学电子期刊资源库"

中华肝脏外科手术学电子杂志 ›› 2022, Vol. 11 ›› Issue (06) : 559 -562. doi: 10.3877/cma.j.issn.2095-3232.2022.06.006

专家论坛

靶向和免疫治疗在肝细胞癌新辅助治疗中的应用
傅仰楷1, 严茂林1,()   
  1. 1. 350000 福州,福建省立医院肝胆胰外科
  • 收稿日期:2022-08-15 出版日期:2022-12-10
  • 通信作者: 严茂林
  • 基金资助:
    福建省自然科学基金(2020J011105)

Application of targeted therapy and immunotherapy in neoadjuvant therapy of hepatocellular carcinoma

Yangkai Fu1, Maolin Yan1()   

  • Received:2022-08-15 Published:2022-12-10
  • Corresponding author: Maolin Yan
引用本文:

傅仰楷, 严茂林. 靶向和免疫治疗在肝细胞癌新辅助治疗中的应用[J]. 中华肝脏外科手术学电子杂志, 2022, 11(06): 559-562.

Yangkai Fu, Maolin Yan. Application of targeted therapy and immunotherapy in neoadjuvant therapy of hepatocellular carcinoma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2022, 11(06): 559-562.

我国是肝细胞癌(HCC)大国,全世界约半数新发HCC患者来自中国,每年死亡病例数占全球55%以上[1,2]。HCC作为我国第4位常见的恶性肿瘤,其病死率占癌症相关死亡原因的第2位[3]。目前HCC的治疗方式包括根治性治疗(手术切除、肝移植、射频消融、微波消融)、系统治疗(靶向治疗、免疫治疗)、支持治疗等。BCLC分期0~A期患者可选择肝切除、射频消融和肝移植;而B期和C期患者只能分别选择TACE和系统治疗。我国《原发性肝癌诊疗规范(2019年版)》将肝切除术的适应证从Ⅰa期扩展到Ⅲa期(BCLC分期A期到C期)。特别是部分具有高危复发因素的中晚期HCC纳入手术适应证后,其远期疗效不甚理想。

[1]
Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
[2]
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249.
[3]
Cao W, Chen HD, Yu YW, et al. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020[J]. Chin Med J, 2021, 134(7):783-791.
[4]
European Association For The Study Of The Liver, European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma[J]. J Hepatol, 2012, 56(4):908-943.
[5]
Mazzaferro V, Lencioni R, Majno P. Early hepatocellular carcinoma on the procrustean bed of ablation, resection, and transplantation[J]. Semin Liver Dis, 2014, 34(4):415-426.
[6]
Lu LC, Cheng AL, Poon RT. Recent advances in the prevention of hepatocellular carcinoma recurrence[J]. Semin Liver Dis, 2014, 34(4):427-434.
[7]
Bruix J, Gores GJ, Mazzaferro V. Hepatocellular carcinoma: clinical frontiers and perspectives[J]. Gut, 2014, 63(5):844-855.
[8]
中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗指南(2022年版)[J]. 中华消化外科杂志, 2022, 21(2):143-168.
[9]
Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial[J]. Lancet, 2018, 391(10126):1163-1173.
[10]
Golse N, Radenne S, Rode A, et al. Liver transplantation after neoadjuvant sorafenib therapy: preliminary experience and literature review[J]. Exp Clin Transplant, 2018, 16(2):227-236.
[11]
Eilard MS, Andersson M, Naredi P, et al. A prospective clinical trial on sorafenib treatment of hepatocellular carcinoma before liver transplantation[J]. BMC Cancer, 2019, 19(1):568.
[12]
Rozeman EA, Menzies AM, van Akkooi ACJ, et al. Identification of the optimal combination dosing schedule of neoadjuvant ipilimumab plus nivolumab in macroscopic stage Ⅲ melanoma (OpACIN-neo): a multicentre, phase 2, randomised, controlled trial[J]. Lancet Oncol, 2019, 20(7):948-960.
[13]
Forde PM, Chaft JE, Smith KN, et al. Neoadjuvant PD-1 blockade in resectable lung cancer[J]. N Engl J Med, 2018, 378(21):1976-1986.
[14]
Powles T, Kockx M, Rodriguez-Vida A, et al. Clinical efficacy and biomarker analysis of neoadjuvant atezolizumab in operable urothelial carcinoma in the ABACUS trial[J]. Nat Med, 2019, 25(11):1706-1714.
[15]
Chalabi M, Fanchi LF, Dijkstra KK, et al. Neoadjuvant immunotherapy leads to pathological responses in MMR-proficient and MMR-deficient early-stage colon cancers[J]. Nat Med, 2020, 26(4):566-576.
[16]
Nanda R, Liu MC, Yau C, et al. Effect of pembrolizumab plus neoadjuvant chemotherapy on pathologic complete response in women with early-stage breast cancer: an analysis of the ongoing phase 2 adaptively randomized I-SPY2 trial[J]. JAMA Oncol, 2020, 6(5):676-684.
[17]
Marron TU, Fiel MI, Hamon P, et al. Neoadjuvant cemiplimab for resectable hepatocellular carcinoma: a single-arm, open-label, phase 2trial[J]. Lancet Gastroenterol Hepatol, 2022, 7(3):219-229.
[18]
Kaseb AO, Hasanov E, Cao HST, et al. Perioperative nivolumab monotherapy versus nivolumab plus ipilimumab in resectable hepatocellular carcinoma: a randomised, open-label, phase 2 trial[J]. Lancet Gastroenterol Hepatol, 2022, 7(3):208-218.
[19]
Ho WJ, Zhu Q, Durham J, et al. Neoadjuvant cabozantinib and nivolumab converts locally advanced HCC into resectable disease with enhanced antitumor immunity[J]. Nat Cancer, 2021, 2(9):891-903.
[20]
Shi YH, Ji Y, Liu WR, et al. A phaseⅠb/Ⅱ, open-label, multi-center study evaluating the efficacy and safety of neoadjuvant toripalimab injection (JS001) or toripalimab in combination with lenvatinib for patients with resectable hepatocellular carcinoma (HCC)[C/OL]//American Association for Cancer Research Annual Meeting, Philadelphia, 2021[2022-07-18].

URL    
[21]
Saâda-Bouzid E, Defaucheux C, Karabajakian A, et al. Hyperprogression during anti-PD-1/PD-L1 therapy in patients with recurrent and/or metastatic head and neck squamous cell carcinoma[J]. Ann Oncol, 2017, 28(7):1605-1611.
[22]
Zhu XD, Huang C, Shen YH, et al. Downstaging and resection of initially unresectable hepatocellular carcinoma with tyrosine kinase inhibitor and anti-PD-1 antibody combinations[J]. Liver Cancer, 2021, 10(4):320-329.
[1] 衣晓丽, 胡沙沙, 张彦. HER-2低表达对乳腺癌新辅助治疗疗效及预后的影响[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 340-346.
[2] 王得晨, 杨康, 杨自杰, 归明彬, 屈莲平, 张小凤, 高峰. 结直肠癌微卫星稳定状态和程序性死亡、吲哚胺2,3-双加氧酶关系的研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(06): 462-465.
[3] 魏小勇. 原发性肝癌转化治疗焦点问题探讨[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 602-607.
[4] 张其坤, 商福超, 李琪, 栗光明, 王孟龙. 联合脾切除对肝癌合并门静脉高压症患者根治性切除术后的生存获益分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 613-618.
[5] 严庆, 刘颖, 邓斐文, 陈焕伟. 微血管侵犯对肝癌肝移植患者生存预后的影响[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 624-629.
[6] 张文华, 陶焠, 胡添松. 不同部位外生型肝癌临床病理特点及其对术后肝内复发和预后影响[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 651-655.
[7] 韩宇, 张武, 李安琪, 陈文颖, 谢斯栋. MRI肝脏影像报告和数据系统对非肝硬化乙肝患者肝细胞癌的诊断价值[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 669-673.
[8] 张维志, 刘连新. 基于生物信息学分析IPO7在肝癌中的表达及意义[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 694-701.
[9] 陈安, 冯娟, 杨振宇, 杜锡林, 柏强善, 阴继凯, 臧莉, 鲁建国. 基于生物信息学分析CCN4在肝细胞癌中表达及其临床意义[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 702-707.
[10] 叶文涛, 吴忠均, 廖锐. 癌旁组织ALOX15表达与肝癌根治性切除术后预后的关系[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 708-712.
[11] 吴晨瑞, 廖锐, 贺强, 潘龙, 黄平, 曹洪祥, 赵益, 王永琛, 黄俊杰, 孙睿锐. MDT模式下肝动脉灌注化疗联合免疫靶向治疗肝细胞癌多处转移一例[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 713-716.
[12] 杜锡林, 谭凯, 贺小军, 白亮亮, 赵瑶瑶. 肝细胞癌转化治疗方式[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 597-601.
[13] 胡宝茹, 尚乃舰, 高迪. 中晚期肝细胞癌的DCE-MRI及DWI表现与免疫治疗预后的相关性分析[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 399-403.
[14] 岳瑞雪, 孔令欣, 郝鑫, 杨进强, 韩猛, 崔国忠, 王建军, 张志生, 孔凡庭, 张维, 何文博, 李现桥, 周新平, 徐东宏, 胡崇珠. 乳腺癌HER2蛋白表达水平预测新辅助治疗疗效的真实世界研究[J]. 中华临床医师杂志(电子版), 2023, 17(07): 765-770.
[15] 符梅沙, 周玉华, 李慧, 薛春颜. 淋巴细胞免疫治疗对复发性流产患者外周血T淋巴细胞亚群分布与PD1/PD-L1表达的影响及意义[J]. 中华临床医师杂志(电子版), 2023, 17(06): 726-730.
阅读次数
全文


摘要