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晚期肝细胞癌转化治疗的挑战与思考

卢实春

引用本文:
Citation:

晚期肝细胞癌转化治疗的挑战与思考

DOI: 10.12449/JCH240904
利益冲突声明:本文不存在任何利益冲突。
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    通信作者:

    卢实春, lsc620213@aliyun.com (ORCID: 0000-0003-3278-0534)

Challenges and reflections on conversion therapy for advanced hepatocellular carcinoma

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  • 摘要: 近年伴随生物治疗药物不断涌现,晚期肝癌系统治疗取得了巨大进展。免疫阻断点抑制剂抗体联合抗血管生成靶向药物已成为晚期肝癌治疗的一线推荐方案并取得明确的肿瘤学获益与生存获益;免疫靶向联合局部治疗研究方案不断涌现,明确提高了客观反应率;靶免转化序贯外科治疗方案正在重塑晚期肝癌治疗格局,最终提高了根治性手术切除率与远期生存率。这场由免疫治疗±靶向治疗为基本架构引导的治疗新变局中,注定挑战不断,思考亦须随行。以免疫靶向联合转化序贯外科方案探索为例来看,任一适用方案在被广泛、成熟地应用于常规诊疗之前,均应包括药物联用方案的选择、疗效的评估、毒副反应的处理、手术标准与时机、术后辅助治疗方案、长期生存获益验证、原发与继发耐药的后线治疗方案的选择等一系列新问题与挑战。本文将择其部分要点提供一些建议与思考。

     

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    [2] Professional Committee for Prevention and Control of Hepatobiliary and Pancreatic Diseases of Chinese Preventive Medicine Association, Chinese Society of Liver Cancer, Liver Study Group of Surgery Committee of Beijing Medical Association, et al. Chinese expert consensus on conversion therapy of immune checkpoint inhibitors combined antiangiogenic targeted drugs for advanced hepatocellular carcinoma(2021 Edition)[J]. Chin J Hepatobiliary Surg, 2021, 27( 4): 241- 251. DOI: 10.3760/cma.j.cn113884-20210415-00138.

    中华预防医学会肝胆胰疾病预防与控制专业委员会, 中国抗癌协会肝癌专业委员会, 北京医学会外科学分会肝脏学组, 等. 基于免疫联合靶向方案的晚期肝细胞癌转化治疗中国专家共识(2021版)[J]. 中华肝胆外科杂志, 2021, 27( 4): 241- 251. DOI: 10.3760/cma.j.cn113884-20210415-00138.
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    李雪瑞, 李俊锋, 张雯雯, 等. 免疫联合靶向序贯外科根治性手术方案治疗初始不可切除肝细胞癌的远期疗效[J]. 中华肝胆外科杂志, 2024, 30( 1): 9- 14. DOI: 10.3760/cma.j.cn113884-20231130-00147.
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    李俊锋, 袁静, 张雯雯, 等. 存活肿瘤细胞比例在初始不可切除肝细胞癌患者转化序贯外科治疗预后评估中的应用[J]. 中华肝胆外科杂志, 2024, 30( 4): 241- 247. DOI: 10.3760/cma.j.cn113884-20240226-00056.
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    冉子坤, 唐浩文, 曹银彪, 等. 初始不可切除肝细胞癌免疫联合靶向序贯外科根治性手术术后辅助治疗效果分析[J]. 中华外科杂志, 2024, 62( 6): 543- 548. DOI: 10.3760/cma.j.cn112139-20240207-00068.
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  • 收稿日期:  2024-07-14
  • 录用日期:  2024-07-28
  • 出版日期:  2024-09-25
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