[APPLE2012]TACE联合索拉菲尼治疗晚期肝癌——韩国宏教授专访

StephenW

                        [APPLE2012]TACE联合索拉菲尼治疗晚期肝癌——韩国宏教授专访                    

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                        来源： 作者：韩国宏 发布时间：2012-7-30 14:06:05   阅读：20

                    
                                                                通常治疗开始时应用索拉菲尼，几天以后，我们会根据指南应用TACE，大部分患者会有可控制范围内的副反应。TACE是一种局部治疗，而索拉菲尼是系统性治疗，5-fu也是系统治疗，所以与联合5-Fu系统治疗比较，联合局部与系统治疗可能会降低症状。靶向治疗效果会更好。而且，没有证据证实5-Fu治疗肝癌更有效。
                    
                                                                                       

　　Hepatology Digest: Is it now clear that sorafenib in combination with other treatments is more effective than sorafenib alone?
　　《国际肝病》：现在是否明确了索拉菲尼联合其他治疗比单用更有效？
　　Dr. Han: Yes， I believe it is， especially for intermediate and advanced stage patients. In select patients， the combination therapy is better than single use. If the patients have well-preserved liver function， we will treat them using combination therapy.
　　韩国宏教授：是的，我认为是的，特别是对中到重度的患者。在筛选出的患者中，联合治疗更优于单药治疗。如果患者肝功能很好，我们会用联合疗法治疗他们。
　　HD: Hand-foot syndrome seems to be a common side effect when sorafenib is used in combination with 5-FU drugs. Would these side effects be reduced by using sorafenib with TACE instead to treat HCC patients?
　　《国际肝病》：当应用索拉菲尼联合5-Fu治疗的时候，手足综合症似乎是常见的副作用。当应用索拉菲尼进行肝动脉化疗栓塞术（TACE）治疗肝癌患者时，这些副反应是否会降低？
　　Dr. Han: Usually， treatment is begun with sorafenib. After several days， we will begin TACE according to the guidelines. Most patients will have manageable side effects. TACE is a kind of regional therapy， while sorafenib is systemic， so the combination of local with systemic may offer reduced symptoms than a combination of systemic with 5-FU， which is also systemic. Targeted treatments offer better results. Furthermore， no evidence has confirmed that 5-FU is even effective on HCC.
　　韩国宏教授：通常治疗开始时应用索拉菲尼，几天以后，我们会根据指南应用TACE，大部分患者会有可控制范围内的副反应。TACE是一种局部治疗，而索拉菲尼是系统性治疗，5-fu也是系统治疗，所以与联合5-Fu系统治疗比较，联合局部与系统治疗可能会降低症状。靶向治疗效果会更好。而且，没有证据证实5-Fu治疗肝癌更有效。
　　HD: Here at the APPLE conference， many doctors will present their latest findings on molecularly targeted therapies and drugs to supplement sorafenib’s actions on advanced HCC. Which fields of research do you feel have the most promise?
　　《国际肝病》：在亚太肝病学会年会上，很多医生都带来了他们在分子靶向治疗方法和药物上的最新进展，这可以辅助索拉菲尼对晚期肝癌的进行治疗。您认为哪个领域的研究最有希望？
　　Dr. Han: I’m interested in the combination of molecular therapy with local or regional reagents， such as Y90， TACE， and ablation. One promising development for us in China is TACE combined with sorafenib， because most patients here are treated with TACE. As China has more cases of HCC than any other country in the world， there is a large potential here to test TACE and sorafenib combination therapy. We need to improve the efficacy of the TACE procedure and reduce toxicity for patients， so we have concentrated our research in this field. This APPLE conference has covered a wealth of topics from basic research to clinical practice， but I think identifying and using the correct biomarkers is the most interesting field. These biomarkers can be used to stratify patients according to their sensitivity to treatment， either to sorafenib or other therapies， and thus allow for improved outcomes in patients.
　　韩国宏教授：我对分子靶向疗法联合局部化疗栓塞比较感兴趣，例如Y90，TACE，消融术。对我们中国来说，一个有前途的治疗是TACE联合索拉菲尼，因为大部分患者都用TACE治疗。中国比世界上其他国家的肝癌病例都多，这里有大量病例可以观察TACE、索拉菲尼联合疗法。我们需要提高TACE手术的效果，降低毒性，因此我们的研究集中在这个领域。这次亚太肝病学会年会的话题很丰富，从基础研究到临床实践，但我认为挑选、应用正确的生物标志物是最有意思的领域。这些生物标志物可以用来根据对治疗的敏感性区分患者，这对索拉菲尼或其他治疗都适用，如此可提高患者的预后。
　　HD:Could you please share your opinion on the future direction of HCC treatment in China?
　　《国际肝病》：您能谈下对未来中国肝癌治疗发展方向的看法么？
　　Dr. Han: Although China has the most cases of HCC in the world， we still lack data and publications. We need more Chinese doctors to understand the advancements in this field， not just in operations and procedures， but also in the importance of summarizing and analyzing their data. In this way， we can make the world recognize China’s achievements in the field of HCC treatment.
　　韩国宏教授：虽然中国有世界上有最多的病例，但我们仍缺乏数据和文章。我们不仅需要更多的中国医生了解这个领域中在手术上、诊疗常规上的进展；也要理解总结、分析相关数据的重要性。这样，我们才能让世界认识到中国在肝癌治疗领域上的成就。
　　HD: Do you think treatment for HCC in China will change in the next few years?
　　《国际肝病》：您认为中国对肝癌的治疗在未来几年会有变化么？
　　韩国宏教授：这不是很容易的。要需要很长时间来转变到分子靶向药物治疗。我们需要时间让医生认识哪种治疗对患者是最好的。
　　Dr. Han: It is not easy. It will take a long period of time to make the switch to molecularly targeted drugs. We need time to let doctors know which treatment is best for patients.