| 免疫检查点抑制剂在肝细胞癌新辅助治疗中的研究进展 |
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| 引用本文： | 陈顺,赵宝银,贾栋,仵朝晖,王盼,谢小青,于晓辉. 免疫检查点抑制剂在肝细胞癌新辅助治疗中的研究进展[J]. 中国肿瘤临床, 2022, 49(19): 1015-1020. DOI: 10.12354/j.issn.1000-8179.2022.20220872 |
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| 作者姓名： | 陈顺 赵宝银 贾栋 仵朝晖 王盼 谢小青 于晓辉 |
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| 作者单位： | 联勤保障部队第九四〇医院消化内科，甘肃省干细胞与基因药物重点实验室（兰州市730050） |
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| 基金项目： | 本课题受甘肃省重点研发计划（编号:20YF8FA099）、甘肃省青年科技基金（编号:21JR7RA012）和甘肃省非感染性肝病临床医学研究中心（编号:21JR7RA017）项目资助 |
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| 摘 要： | 肝细胞癌（hepatocellular carcinoma，HCC）是全球最常见的恶性肿瘤之一，也是世界范围内癌症相关死亡的主要原因。尽管在诊断和治疗方面已经有了较大的进步，但是针对早期HCC的治疗，目前最佳的治疗方式仍然是手术切除和肝移植。然而，术后高复发率、转移率使得患者长期生存仍然面临挑战。近年来以免疫检查点抑制剂（immune checkpoint inhibitors，ICIs）为代表的免疫治疗以其良好的安全性和客观反应性为晚期HCC患者的治疗提供了新的机遇，因此也成为新辅助治疗的候选药物。当前，在新辅助治疗环境下利用免疫治疗来增加HCC治愈机会成为研究的热点。与此同时，也存在着诸多问题亟待解决，如新辅助免疫治疗的时间与疗程、效果的评估、筛选适合治疗的目标人群以及治疗的安全性和肝毒性等。本文对HCC新辅助免疫治疗的现有文献和临床试验进行探讨和总结，并对其进行分析与展望。
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| 关 键 词： | 肝细胞癌 免疫治疗 新辅助治疗 免疫检查点抑制剂 |
| 收稿时间： | 2022-06-14 |
Research progress of immune checkpoint inhibitors in the neoadjuvant therapy for hepatocellular carcinoma |
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| Affiliation: | Department of Gastroenterology, Medical Experimental Center of the 940th Hospital of Joint Logistics Support Force of PLA, Key Laboratory of Stem Cells and Gene Drugs of Gansu Province, Lanzhou 730050, China |
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| Abstract: | Hepatocellular carcinoma (HCC) is one of the most common malignancies and the third leading cause of cancer-related mortality globally. Despite significant advances in diagnosis and treatment, the best treatment for early-stage HCC is surgical resection and liver transplantation. However, due to the high recurrence and metastasis rates after surgery, the long-term survival of patients remains challenging. In recent years, immunotherapy—represented by immune checkpoint inhibitors (ICIs)—has offered new opportunities for the treatment of advanced HCC, with a favorable safety profile and encouraging objective responsiveness. Thus, it has emerged as a promising candidate for the development of effective neoadjuvant therapies. The use of immunotherapy in a neoadjuvant setting to increase the efficacy of HCC treatment is currently a hot research topic. However, there are many issues that need to be addressed, such as the timing and duration of neoadjuvant immunotherapy, the criteria used to evaluate its effectiveness, screening target populations to identify those suitable for treatment, and the safety and hepatotoxicity of the treatment. In this review, we summarize the current literature and clinical trials on neoadjuvant immunotherapy for HCC, present an analysis of these data, and suggest future prospects. |
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