晚期肝细胞癌的系统治疗

Systemic therapy for advanced hepatocellular carcinoma

肝细胞癌是全球范围内发病率和死亡率前列的恶性肿瘤。随着分子生物学和肿瘤免疫学的进步,以酪氨酸激酶抑制剂(如索拉非尼、仑伐替尼等)为代表的分子靶向药物和以程序性死亡受体-1/程序性死亡配体-1单抗为代表的免疫治疗为晚期肝细胞癌患者带来福音。免疫治疗联合抗血管生成治疗可进一步提高疗效。此外,立体定向放疗、局部治疗与系统治疗的优化整合有望使得患者获益最大化。未来,深入理解肝细胞癌异质性,发展精准分子分型和个体化治疗,建立多学科协作诊疗体系,系统治疗有望实现晚期肝细胞癌的长期管理。本文就晚期肝细胞癌系统治疗的研究现状和进展作一综述。

Hepatocellular carcinoma(HCC)is one of the most common malignancies with high morbidity and mortality rates worldwide.With the advances in molecular biology and tumor immunology,molecular-targeted agents represented by tyrosine kinase inhibitors(such as sorafenib and lenvatinib)and immunotherapy represented by PD-1/PD-L1 monoclonal antibodies have brought hope for patients with advanced HCC.The combination of immunotherapy and anti-angiogenic therapy can further improve the treatment outcome of patients.In addition,the optimization and integration of stereotactic body radiotherapy,local treatment,and systemic treatment may maximize the benefits of patients.In the future,through a deep understanding of the heterogeneity of HCC,the development of precision molecular subtyping and individualized treatment,and the establishment of a multidisciplinary collaborative diagnosis and treatment system,systemic therapy is expected to achieve long-term management of advanced HCC.This article reviews the current status and advances in systemic therapy for advanced HCC.