2021年9月肝细胞癌治疗方案的范式转变

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肝细胞癌治疗方案的范式转变    2021年9月肝脏国际：国际肝脏研究协会官方期刊    DOI：10.1111/liv.15052    Tung-Hung SuTung-Hung SuShih-Jer HsuShih-Jer Hsujia-Horng KaoJia-Horng Kao0.9引文01个新114个新16文献评论文章肝细胞癌治疗方案的范式转变下载相关的研究晚期肝细胞癌的全身治疗文章全文可用    2020 年 3 月下载查看更多抽象的肝细胞癌 (HCC) 在世界范围内普遍存在，但治疗效果不佳。治疗选择的进步和新全身疗法的开发扩大了治疗 HCC 的医疗器械。应根据多学科角度的疗效等级提供治疗方案，而不是传统的分期指导方案。在晚期 HCC 中，乐伐替尼在 HCC 的一线治疗中具有与索拉非尼相当的疗效；而瑞戈非尼、卡博替尼和雷莫芦单抗已被批准作为索拉非尼失败后的二线治疗。免疫检查点抑制剂治疗可延长缓解率和生存期，并实现长期治愈。 Atezolizumab 加贝伐珠单抗作为晚期 HCC 的一线治疗优于索拉非尼。多种系统疗法相结合的几种新兴方案目前正在临床试验中。全身治疗可用于新辅助、辅助，甚至作为中期 HCC 的初始治疗。 HCC 治疗的范式转变将改善患者的预后。

StephenW

Paradigm Shift in the Treatment Options of Hepatocellular Carcinoma

    September 2021Liver international: official journal of the International Association for the Study of the Liver

    DOI: 10.1111/liv.15052

    Tung-Hung SuTung-Hung SuShih-Jer HsuShih-Jer HsuJia-Horng KaoJia-Horng Kao

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Paradigm Shift in the Treatment Options of Hepatocellular Carcinoma
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Abstract
Hepatocellular carcinoma (HCC) is prevalent worldwide with suboptimal therapeutic outcomes. The advancement of therapeutic options and the development of new systemic therapies expand the armamentarium to tackle HCC. Treatment options should be provided based on the hierarchy of efficacy in a multidisciplinary perspective, instead of the traditional stage-guided scheme. In advanced HCC, lenvatinib has a comparable efficacy as sorafenib for the first-line therapy of HCC; while regorafenib, cabozantinib, and ramucirumab have been approved as second-line therapy after failure of sorafenib. Immune checkpoint inhibitor therapy prolongs response rate and survival and enables long-term cure. Atezolizumab plus bevacizumab is superior to sorafenib as the first-line therapy for advanced HCC. Several emerging regimens by the combination of various systemic therapies are currently under clinical trials. Systemic therapy may be used in the neoadjuvant, adjuvant, or even as initial therapy for intermediate-stage HCC. The paradigm shift of HCC treatment will improve patient outcomes.

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