《2021年欧洲肿瘤内科学会肝细胞癌临床实践指南更新》解读Interpretation of Updated treatment recommendations for hepatocellular carcinoma (HCC) from the ESMO Clinical Practice Guidelines
张德耀;陈敏山;
摘要(Abstract):
原发性肝癌是全球范围内最常见的恶性肿瘤之一,其发病率居所有恶性肿瘤的第6位,死亡率居第4位。原发性肝癌中90%以上的病例为肝细胞癌(以下简称肝癌)。近几年,随着各项临床研究的开展,肝癌的治疗模式由单一的局部治疗转变为多学科综合治疗模式。2021年5月,欧洲肿瘤内科学会在Annals of Oncology杂志发布了《2021年欧洲肿瘤内科学会肝细胞癌临床实践指南更新》。本文将对指南的更新内容进行解读。
关键词(KeyWords): 原发性肝癌;肝细胞癌;免疫治疗;进展
基金项目(Foundation): 国家自然科学基金面上项目(81874070)
作者(Authors): 张德耀;陈敏山;
参考文献(References):
- [1]SIEGEL R L,MILLER K D,FUCHS H E,et al.Cancer Statistics,2021[J].CA Cancer J Clin,2021,71(1):7-33.
- [2]VOGEL A,MARTINELLI E,ESMO Guidelines Committee.Updated treatment recommendations for hepatocellular carcinoma (HCC) from the ESMO Clinical Practice Guidelines[J].Ann Oncol,2021,32(6):801-805.
- [3]DI MARCO V,DE VITA F,KOSKINAS J,et al.Sorafenib:from literature to clinical practice[J].Ann Oncol,2013,24 Suppl 2:ii30-ii37.
- [4]KUDO M,FINN R S,QIN S,et al.Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma:a randomised phase 3 non-inferiority trial[J].Lancet,2018,391(10126):1163-1173.
- [5]ABOU-ALFA G K,MEYER T,CHENG A L,et al.Cabozantinib in Patients with Advanced and Progressing Hepatocellular Carcinoma[J].N Engl J Med,2018,379(1):54-63.
- [6]ZHU A X,KANG Y K,YEN C J,et al.Ramucirumab after sorafenib in patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations (REACH-2):a randomised,double-blind,placebo-controlled,phase 3 trial[J].Lancet Oncol,2019,20(2):282-296.
- [7]EL-KHOUEIRY A B,SANGRO B,YAU T,et al.Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040):an open-label,non-comparative,phase 1/2 dose escalation and expansion trial[J].Lancet,2017,389(10088):2492-2502.
- [8]ZHU A X,FINN R S,EDELINE J,et al.Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224):a non-randomised,open-label phase 2 trial[J].Lancet Oncol,2018,19(7):940-952.
- [9]YAU T,PARK J W,FINN R S,et al.CheckMate 459:A randomized,multi-center phase Ⅲ study of nivolumab (NIVO) vs sorafenib (SOR) as first-line (1L) treatment in patients (pts) with advanced hepatocellular carcinoma (aHCC)[J].Ann Oncol,2019,30 Suppl 5:874-875.
- [10]FINN R S,RYOO B Y,MERLE P,et al.Pembrolizumab As Second-Line Therapy in Patients With Advanced Hepatocellular Carcinoma in KEYNOTE-240:A Randomized,Double-Blind,Phase Ⅲ Trial[J].J Clin Oncol,2020,38(3):193-202.
- [11]LEE M S,RYOO B Y,HSU C H,et al.Atezolizumab with or without bevacizumab in unresectable hepatocellular carcinoma (GO30140):an open-label,multicentre,phase 1b study[J].Lancet Oncol,2020,21(6):808-820.
- [12]SANGRO B,CARPANESE L,CIANNI R,et al.Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages:a European evaluation[J].Hepatology,2011,54(3):868-878.
- [13]CHOW P K H,GANDHI M,TAN S B,et al.SIRveNIB:Selective Internal Radiation Therapy Versus Sorafenib in Asia-Pacific Patients With Hepatocellular Carcinoma[J].J Clin Oncol,2018,36(19):1913-1921.
- [14]HE M,LI Q,ZOU R,et al.Sorafenib Plus Hepatic Arterial Infusion of Oxaliplatin,Fluorouracil,and Leucovorin vs Sorafenib Alone for Hepatocellular Carcinoma With Portal Vein Invasion:A Randomized Clinical Trial[J].JAMA Oncol,2019,5(7):953-960.
- [15]陈敏山,元云飞,郭荣平,等.肝动脉灌注化疗在肝癌转化治疗中的应用——中山大学肿瘤防治中心的经验总结[J].中国医学前沿杂志(电子版),2021,13(3):70-76.