新型抗肿瘤药治疗肝癌的研究进展

Research progress of new anti-tumor drugs for hepatocellular carcinoma

原发性肝细胞癌(简称肝癌)是临床常见的恶性肿瘤之一,具有发病率高、预后差、死亡率高的特点,其发病率和死亡率均在全球恶性肿瘤中的排名前列。肝癌的高度异质性影响肿瘤的进展及治疗反应。由于大多数肝癌患者确诊已是晚期,系统治疗成为主要的治疗选择。索拉非尼是2007年推出的第一种多激酶抑制剂,且是之后十多年来唯一可供肝癌患者选择的靶向药物。直到2017年,另一种多激酶抑制剂仑伐替尼获批肝癌一线系统治疗。此外,免疫检查点抑制剂(ICIs)已经成为许多实体肿瘤(包括肝癌)有效的治疗方法。多项大型临床试验研究表明这些ICIs已被证明在治疗晚期HCC方面具有疗效。目前,许多晚期肝癌的临床试验正在进行中,这将给晚期肝癌患者的治疗带来持续的变化,并提高患者的生存率。本文总结了目前肝癌系统治疗的主要药物,讨论了目前在临床试验中的潜在药物可能,并讨论了今后肝癌系统治疗的发展方向。

Hepatocellular carcinoma(HCC)is one of the most common malignant tumors in clinic.It has the characteristics of high incidence rate,poor prognosis and high mortality.Its incidence rate and mortality rate are among the top in the global malignant tumors.The high heterogeneity of HCC affects the tumor progression and therapeutic response.Because most patients with liver cancer have been diagnosed as advanced,systematic treatment has become the main treatment option.Sorafenib is the first multi kinase inhibitor launched in 2007,and is the only targeted drug that can be selected by patients with liver cancer for more than ten years.Until 2017,another multikinase inhibitor,ranvartinib,was approved for first-line systematic treatment of liver cancer.In addition,immunocheckpoint inhibitors(ICIs)have become an effective treatment for many solid tumors(including liver cancer).A number of large clinical trials have shown that these ICIs have proven to be effective in the treatment of advanced HCC.At present,many clinical trials of advanced liver cancer are in progress,which will bring continuous changes to the treatment of patients with advanced liver cancer and improve the survival rate of patients.This article summarized the main drugs for systematic treatment of liver cancer,discussed the potential drugs in clinical trials at present,and discussed the development direction of systematic treatment of liver cancer in the future.