靶向联合免疫时代肝细胞癌转化治疗策略

Conversion therapy strategies for hepatocellular carcinoma in the era of targeted therapy combined with immunotherapy

肝细胞癌(以下简称肝癌)发病隐匿, 多数患者就诊时已达中晚期, 错失根治性治疗时机, 导致较差的预后结局。转化治疗为不可切除肝癌创造可切除机会, 是改善患者预后的重要手段。随着新型靶向药物、抗血管药物、免疫药物及多维治疗方案在肝癌治疗中带来更高的客观缓解率、更长的缓解持续时间, 转化治疗成为肝癌临床研究的热点。靶向联合免疫治疗时代下肝癌转化治疗内涵不断拓展、转化策略不断更新, 肝癌转化治疗进入快速发展期, 但仍然面临诸多挑战。笔者结合自身临床经验及最新研究进展, 基于以靶向联合免疫治疗为核心的系统治疗及联合局部治疗等手段在中晚期肝癌中的疗效, 对新时代下转化治疗的定义与拓展、肿瘤学转化治疗策略等内容进行深入阐述。

Hepatocellular carcinoma(HCC)has an insidious onset,and most HCC patients have reached the intermediate-advanced stage when they were diagnosed,which lead to missing the opportunity for radical treatment and suffering a poor prognosis.Conversion therapy is an important tool to improve the prognosis of patients with unresectable HCC by creating resectable opportunities.With the new targeted agents,anti-vascular agents,immune agents and multi-dimensional treatment regimens bringing high objective response rate and long duration of remission in HCC treatment,conversion therapy has emerged as a hot spot in the clinical research of HCC.In the era of targeted therapy combined with immunotherapy,the connotation of conversion therapy for HCC continues to expand,with strategies constantly being updated.As such,conversion therapy for HCC has entered a rapid development period,but still faces many challenges.Combined with clinical experience and the latest research progress,based on the efficacy of systematic therapy with targeted combined immunotherapy as the core and combined local therapy in advanced HCC,the authors summarize the definition and expansion of conversion therapy and the conversion therapy strategies in oncology.