免疫检查点抑制剂在肝细胞癌治疗中的特征

肝细胞癌(HCC)在全球和中国均存在沉重的疾病负担,而且晚期HCC缺乏有效的系统治疗药物。近年来,纳武利尤单抗及帕博利珠单抗等免疫检查点抑制剂陆续在美国食品和药品监督管理局获批用于晚期HCC的二线治疗,这种新型治疗具有与传统治疗截然不同的特征,包括持久应答、延迟起效、安全可管理,但需要关注和监测特异性免疫相关不良反应等。本文将以HCC免疫检查点抑制剂治疗的临床试验和真实世界研究数据为基础,综合阐述其长期获益、肿瘤应答及机制、不良反应、特殊人群等多方面的治疗特征。

Features of immune checkpoint inhibitor therapies in patients with hepatoceDular carcinoma

The disease burden of hepatocellular carcinoma(HOC)remains large both in China and globally.In particular,advanced HCC lacks of effective systemic therapeutic drugs.Recently immune checkpoint inhibitors such as nivolumab and pembrolizumab have been approved for second-line treatment in patients with advanced HCC by the U.S.Food and Drug Administration(FDA).Compare with traditional chemotherapy or targeted therapy,these novel pharmacological approaches have unique therapeutic features,such as durable response,delayed response and manageable safety profile with specific immune-related adverse events that require monitoring.We aim to summarize the characteristics of immuno-oncology therapies on aspects of long-term outcome,response mechanisms and assessment,safety,and special populations,based on clinical trials and real-world data on patients with HCC.