首页|肝细胞癌化学药物治疗的现状及进展

肝细胞癌化学药物治疗的现状及进展

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随着FOLFOX方案(奥沙利铂、亚叶酸钙、氟尿嘧啶)在肝动脉灌注化疗(HAIC)中的应用,化疗在肝癌综合治疗中显示出更高价值.尤其在免疫治疗联合靶向药物(简称靶免联合治疗)时代,FOLFOX-HAIC联合靶向和免疫治疗进一步提高了临床疗效.笔者团队探索的FOLFOX全身化疗联合免疫和靶向治疗方案取得了类似三联治疗效果.中晚期肝癌更具全身性疾病特征,全身化疗联合靶向和免疫治疗初期探索取得了更高的疾病控制率,其机制可能是全身化疗改变了肿瘤的全身免疫微环境,使肿瘤免疫微环境由免疫抑制性转变为免疫支持性,从而更好增效免疫治疗.未来还需要进一步开展Ⅲ期临床研究及基础研究探索全身化疗在综合治疗中的优化方案,以期达到晚期肝癌治疗更加高效、安全和经济的目标.
Status and progress of chemical drug therapy in hepatocellular carcinoma
With the application of FOLFOX regimen(oxaliplatin,fluorouracil,and leucovorin)in hepatic arterial perfusion(HAIC),chemotherapy has shown a higher value in the comprehensive treatment of hepatocellular carcinoma.Especially in the era of integration of targeted therapy and immunotherapy,the FOLFOX-HAIC,combined with immunotherapy and targeted therapy,further improves antitumor effect.The FOLFOX systemic chemotherapy combined with immunotherapy and targeted therapy scheme explored by the authors has achieved similar effects to triple therapy.Advanced hepatocellular carcinoma exhibits systemic disease characteristics,and systemic chemotherapy combined with targeted and immunotherapy has achieved higher disease control rates in the initial exploration.The mechanism may be that systemic chemotherapy changes the overall immune micro-environment of tumors,transforming the immune microenvironment from immunosuppressive to immune supportive,thereby better enhancing the efficacy of immunotherapy.The optimal regimen of systemic chemotherapy in comprehensive treatment may be obtained from the phase 3 study and basic studies in the future,which will be more efficient,safe and economical in the treatment of advanced hepatocellular carcinoma.

Liver neoplasmsCombinational therapySystemic chemotherapyHepatic arterial infusion chemotherapyImmune checkpoint inhibitorsAntiangio-genic targeted drugs

陈亚进、彭林辉

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中山大学孙逸仙纪念医院肝胆外科,广州 510120

肝肿瘤 联合治疗 全身化疗 肝动脉灌注化疗 免疫检查点抑制剂 抗血管生成靶向药物

国家卫生健康委人才交流服务中心项目广东省消化系统疾病临床医学研究中心项目

RCLX23150492020B1111170004

2024

10.3760/cma.j.cn115610-20240122-00031

中华消化外科杂志
中华医学会

中华消化外科杂志

CSTPCD北大核心
影响因子：1.899
ISSN：1673-9752
年,卷(期)：2024.23(2)
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