新辅助免疫疗法在肝癌中的作用？ — 两项小型试验证明了检

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新辅助免疫疗法在肝癌中的作用？
— 两项小型试验证明了检查点抑制剂在围手术期的安全性和活性

作者：MedPage Today 特约撰稿人 Mike Bassett 2022 年 1 月 25 日
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患有癌症的肝脏的计算机渲染图。

根据两项小型研究的结果，新辅助免疫疗法在肝细胞癌 (HCC) 患者中似乎是可行、安全且有效的。

休斯顿 MD 安德森癌症中心的医学博士 Ahmed Omar Kaseb 及其同事报告说，在第一项研究中，围手术期 nivolumab (Opdivo) 联合或不联合 ipilimumab (Yervoy) 在接受手术的患者中引起了近三分之一的主要病理反应。

在第二项研究中，由纽约市西奈山伊坎医学院的 Thomas U. Marron 医学博士领导的研究人员发现，新辅助西米普利单抗 (Libtayo) 的短期治疗导致 20% 的患者出现明显的肿瘤坏死。患有可切除 HCC 的患者，每个患者都能够进行手术。

II 期试验发表在 Lancet Gastroenterology & Hepatology 上。

“这两项研究在安全性、有效性和组织分析方面提供了某种一致的结果，”意大利米兰人道主义大学的医学博士 Nicola Personeni 和医学博士 Lorenza Rimassa 在研究随附的评论中写道。 “综上所述，他们提出了两种疗法的可接受的安全性，因为所有入选的患者均未因不良事件 [AE] 而取消手术，而由于疾病进展，一小部分患者未接受手术。”

Personeni 和 Rimassa 补充说，结果支持进一步研究使用新辅助免疫疗法治疗 HCC 的途径，“考虑最合适的药物组合、最佳治疗持续时间以及基于危险因素分层的后续术后治疗”。

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A Role for Neoadjuvant Immunotherapy in Liver Cancer?
— Two small trials demonstrate safety, activity of checkpoint inhibitors in perioperative setting

by Mike Bassett, Staff Writer, MedPage Today January 25, 2022
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A computer rendering of a liver with cancer.

Neoadjuvant immunotherapy appears to be feasible, safe, and active in patients with hepatocellular carcinoma (HCC), according to results from two small studies.

In the first study, perioperative nivolumab (Opdivo) with or without ipilimumab (Yervoy) induced major pathological responses in nearly a third of patients who underwent surgery, reported Ahmed Omar Kaseb, MD, of MD Anderson Cancer Center in Houston, and colleagues.

While in the second study, investigators led by Thomas U. Marron, MD, PhD, of Icahn School of Medicine at Mount Sinai in New York City, found that a short course of neoadjuvant cemiplimab (Libtayo) led to significant tumor necrosis in 20% of patients with resectable HCC, with every patient able to go on to surgery.

The phase II trials were published in Lancet Gastroenterology & Hepatology.

"Both studies provide somehow consistent results in terms of safety, efficacy, and tissue analyses," wrote Nicola Personeni, MD, and Lorenza Rimassa, MD, both of Humanitas University in Milan, Italy, in a commentary accompanying the studies. "Taken together, they suggest an acceptable safety profile of both therapies, since none of the patients enrolled had surgery cancelled due to adverse events [AEs], while a minimal fraction did not undergo surgery because of disease progression."

Personeni and Rimassa added that the results support further avenues of investigation into the use of neoadjuvant immunotherapy for HCC that "consider the most appropriate combinations of agents, the optimal therapy duration, and tailoring of subsequent postoperative therapy on the basis of risk factor stratification."

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