以免疫抑制剂为基础的全身系统治疗在晚期肝细胞癌的应用及研究进展

Application and Research Progress of Immunosuppressive Agent-Based Systemic System Therapy in Advanced Hepatocellular Carcinoma

摘要: 自20世纪50年代起化疗开始用于肝癌的全身治疗，全身化疗是最早用于晚期原发性肝癌的内科治疗方式，在EACH研究数据公布之前，传统的全身化疗模式在晚期HCC的治疗上临床数据亟待突破。肝细胞癌的治疗在过去的几年里发生了根本性的变化。而索拉非尼的问世无疑是为肝细胞癌的全身治疗带来了里程碑式突破。近年来，免疫抑制剂治疗如火如荼，免疫检查点抑制剂(PD-1、PD-L1以及CTLA-4)对晚期肝细胞癌表现出潜在的治疗效果，为晚期HCC的治疗开启了治疗新大门。目前随着免疫抑制剂的临床研究的探索，使得越来越多的PD-1/PD-L1免疫抑制剂单药或免疫抑制剂联合疗法或与常规治疗方法相结合应用于更多晚期原发性肝癌患者，而且联合治疗的模式使得每种药物发挥最大的效益，进而实现1 + 1 > 2的临床效果，为晚期原发性肝癌的患者提高生活质量、延长生命提供了更多的可能性。

Abstract: Since the 1950s, chemotherapy has been used in the systemic treatment of liver cancer. Systemic chemotherapy is the earliest medical treatment mode used for advanced primary liver cancer. Before the release of EACH research data, the traditional systemic chemotherapy mode urgently needs to be a breakthrough in the treatment of advanced HCC. The treatment of HCC has changed radically over the last few years. The advent of sorafenib is undoubtedly a milestone in the systemic treatment of hepatocellular carcinoma. In recent years, immunosuppressant therapy has been in full swing, with immune checkpoint inhibitors (PD-1, PD-L1, and CTLA-4) acting against advanced hepatocellular carcinoma The potential therapeutic effect is shown, opening a new door for the treatment of advanced HCC. With the exploration of clinical research of immunosuppressive agents, more and more PD-1/PD-L1 immunosuppressive agent monotherapy or immunosuppressive combination therapy or combined with conventional treatment method are applied to more patients with advanced primary liver cancer, and the combination treatment mode makes each drug play the maximum benefit, thus achieve the clinical effect of 1 + 1 > 2. It provides more possibilities to improve the quality of life and prolong the life for the patients with advanced primary liver cancer.