Anti-programmed cell death ligand 1-based immunotherapy in recurrent hepatocellular carcinoma with inferior vena cava tumor thrombus and metastasis: Three case reports.
Anti-programmed cell death ligand 1-based immunotherapy in recurrent hepatocellular carcinoma with inferior vena cava tumor thrombus and metastasis: Three case reports.
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DOI：
10.12998/wjcc.v9.i21.5988
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发表时间：
2021-07-26
影响因子：
1.1
通讯作者：
Zhang R
中科院分区：
文献类型：
--
作者：
Liu SR;Yan Q;Lin HM;Shi GZ;Cao Y;Zeng H;Liu C;Zhang R
复发性肝细胞癌（HCC）合并下腔静脉癌栓对肿瘤科医生来说是一个巨大的挑战，且预后较差。迄今为止，程序性细胞死亡配体 1 (PD-L1) 抑制剂的安全性和有效性仍不清楚。一名59岁男性，术后3年被查出下腔静脉癌栓。患者接受了第二次手术和辅助化疗。然而，2个月后甲胎蛋白水平升高，并发现肺转移和纵隔淋巴结转移。采用免疫组化方法分析HCC及下腔静脉癌栓组织中PD-L1的表达情况。然后，患者接受了atezolizumab免疫治疗。免疫治疗3个月后，甲胎蛋白水平降至正常，纵隔淋巴结转移灶缩小，肺转移灶消失。随访21个月时，患者未出现复发迹象。一名60岁男性接受左肝肿瘤切除、下腔静脉切开取血栓，随后常规化疗。手术后，患者出现肺和脾转移。使用帕博利珠单抗六个疗程，脾转移灶缩小，随后进行脾切除术。患者继续接受派姆单抗十三个疗程，肺转移未见进展。一名34岁男性，被诊断为肝癌并下腔静脉癌栓。患者接受了右肝切除术并接受了三个疗程的替雷利珠单抗治疗。他仍在接受免疫治疗，状况良好。患有下腔静脉癌栓和转移的 HCC 患者接受抗 PD-L1 治疗可获得相对良好的患者预后。
Recurrent hepatocellular carcinoma (HCC) with inferior vena cava tumor thrombus is a great challenge for oncologists and has a poor prognosis. To date, the safety and efficacy of programmed cell death ligand 1 (PD-L1) inhibitors are still unknown. A 59-year-old male was identified as having a tumor thrombus in the inferior vena cava 3 years after surgery. The patient underwent a second surgery and adjuvant chemotherapy. However, the level of alpha-fetoprotein was elevated after 2 mo, and lung metastases and mediastinal lymph node metastases were identified. The expression of PD-L1 in HCC and inferior vena cava tumor thrombus tissues was analyzed by immunohistochemistry. Then, the patient received atezolizumab immunotherapy. The level of alpha-fetoprotein dropped to normal, the mediastinal lymph node metastases decreased in size and the lung metastases disappeared after 3 mo of immunotherapy. The patient had no signs of recurrence at 21 mo of follow-up. A 60-year-old male underwent left hepatic tumor resection, inferior vena cava incision and thrombus removal, followed by regular chemotherapy. The patient developed lung and splenic metastases after surgery. Pembrolizumab was used for six courses, and the splenic metastasis shrank, after which splenectomy was performed. The patient continued to receive pembrolizumab for thirteen courses, and the lung metastases showed no progression. A 34-year-old male was diagnosed with liver cancer with inferior vena cava tumor thrombus. The patient underwent right hepatectomy and received tislelizumab for three courses. He is still receiving immunotherapy and in good condition. Anti-PD-L1 therapy in HCC patients with inferior vena cava tumor thrombus and metastasis is associated with relatively good patient outcomes.
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DOI：
10.1093/jnci/djx030
发表时间：
2017-09-01
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Jemal A;Ward EM;Johnson CJ;Cronin KA;Ma J;Ryerson B;Mariotto A;Lake AJ;Wilson R;Sherman RL;Anderson RN;Henley SJ;Kohler BA;Penberthy L;Feuer EJ;Weir HK
通讯作者：
Weir HK
影响因子：
158.5
作者：
Finn, Richard S.;Qin, Shukui;Cheng, Ann-Lii
通讯作者：
Cheng, Ann-Lii
影响因子：
158.5
作者：
Schmid, P.;Adams, S.;Emens, L. A.
通讯作者：
Emens, L. A.
影响因子：
8.4
作者：
通讯作者：
--
影响因子：
25.7
作者：
Kokudo, Takashi;Hasegawa, Kiyoshi;Kokudo, Norihiro
通讯作者：
Kokudo, Norihiro