精准医学时代肝细胞癌的系统治疗

祝桂琦; 唐政; 史颖弘; 樊嘉

doi:10.3969/j.issn.1001-5256.2020.10.003

精准医学时代肝细胞癌的系统治疗

DOI: 10.3969/j.issn.1001-5256.2020.10.003

复旦大学附属中山医院肝肿瘤外科

基金项目:

国家自然科学基金重点项目(81530077)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2020-09-14
- 出版日期: 2020-10-20

Research advances in systemic therapy for hepatocellular carcinoma in the era of precision medicine

Department of Liver Surgery & Transplantation,Zhongshan Hospital,Fudan University

Research funding:

摘要

摘要: 肝细胞癌(HCC)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。HCC的高度异质性影响肿瘤的进化及治疗反应。由于大多数HCC患者确诊已是晚期,系统治疗成为主要的治疗选择。近年来HCC分子靶向治疗和免疫治疗方面取得了显著的进展,最新的美国综合癌症网络HCC系统治疗指南显示,索拉非尼、仑伐替尼及阿特珠单抗联合贝伐单抗成为推荐的HCC一线治疗,瑞戈非尼、卡博替尼、纳武单抗、派姆单抗和雷莫芦单抗等是二线治疗选择。在精准医学时代,如何个体化选择最佳系统治疗方案,是HCC系统治疗中的关键问题。就精准医学背景下HCC的系统治疗作一综述,并对今后HCC系统治疗的发展方向进行探讨。
- 癌,肝细胞 /
- 精准医学 /
- 分子靶向治疗 /
- 免疫疗法
Abstract: Hepatocellular carcinoma( HCC) is one of the most common malignant tumors in clinical practice and has the features of high incidence rate,poor prognosis,and high mortality rate,and its incidence rate and mortality rate rank among the top malignant tumors in the world. High heterogeneity of HCC affects the evolution and therapeutic response of HCC. Since most HCC patients are in the advanced stage at the time of diagnosis,systemic treatment has become the main treatment option. In recent years,remarkable achievements have been made in molecular targeted therapy and immunotherapy for HCC,and the latest NCCN guidelines for the systemic treatment of HCC show that sorafenib,lenvatinib,and atezolizumab combined with bevacizumab are recommended as the first-line treatment of HCC,and regorafenib,cabozantinib,nivolumab,pembrolizumab,and ramucirumab are the second-line treatment options for HCC. In the era of precision medicine,how to select the optimal individualized systemic treatment regimen is the key problem in the systemic treatment of HCC. This article reviews the advances in the systemic treatment of HCC in the era of precision medicine and discusses the development direction of HCC treatment in the future.
- carcinoma,hepatocellular /
- precision medicine /
- molecular targeted therapy /
- immunotherapy

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