A case of hepatocellular carcinoma with “pseudoprogression” followed by complete response to atezolizumab plus bevacizumab
A case of hepatocellular carcinoma with “pseudoprogression” followed by complete response to atezolizumab plus bevacizumab
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一例出现“假性进展”的肝细胞癌，随后对阿特朱单抗加贝伐单抗完全缓解
DOI：
10.1007/s12328-023-01761-6
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发表时间：
2023
影响因子：
1
通讯作者：
Kawada Norifumi
中科院分区：
文献类型：
--
作者：
Odagiri Naoshi;Tamori Akihiro;Kotani Kohei;Motoyama Hiroyuki;Kawamura Etsushi;Hagihara Atsushi;Fujii Hideki;Uchida?Kobayashi Sawako;Enomoto Masaru;Kawada Norifumi
Atezolizumab联合贝伐珠单抗（Atezo + Bev）是首个针对肝细胞癌（HCC）的免疫疗法，在目前的指南中，它被定位为不可切除病例的一线化疗。在此，我们报告一例肝癌假性进展，随后阿替佐+贝伐单抗完全缓解。一名56岁男性被诊断为中期HCC，根据巴塞罗那临床肝癌系统分期B定义。计算机断层扫描（CT）显示肝脏多处病变，无任何肝外病变。首先，他接受了经导管动脉化疗栓塞（TACE）治疗;然而，TACE后2个月的CT扫描观察到多个残留病变。因此，在TACE后4个月开始Atezo + Bev治疗。第三次给予Atezo + Bev后，CT扫描显示肝内病变进行性疾病，沿着血清肿瘤标志物水平升高。虽然再次计划TACE，但在患者等待住院期间继续使用Atezo + Bev。第5次给予Atezo + Bev后，肿瘤标志物的血清水平降至正常范围。磁共振成像显示肿瘤大小显著减小。因此，继续使用Atezo + Bev，第8次给药后，CT扫描显示所有肝脏病变消失，表明完全缓解。在免疫治疗中，由于肿瘤负荷增加或出现新病变，有时可以以非典型模式获得治疗反应，称为“假进展”，这在HCC中很少见。
Atezolizumab plus bevacizumab (Atezo + Bev) is the first immunotherapy for hepatocellular carcinoma (HCC), and in the current guidelines, it is positioned as the first-line chemotherapy for unresectable cases. Herein, we report a case of HCC with pseudoprogression followed by a complete response to Atezo + Bev. A 56 year-old man was diagnosed with intermediate-stage HCC, as defined by the Barcelona Clinic Liver Cancer system stage B. Computed tomography (CT) revealed multiple lesions in the liver without any extrahepatic lesions. First, he was treated with transcatheter arterial chemoembolization (TACE); however, multiple residual lesions were observed on CT scan 2 months after TACE. Therefore, treatment with Atezo + Bev was initiated 4 months after TACE. After the third administration of Atezo + Bev, a CT scan showed progressive disease in intrahepatic lesions, along with increased serum levels of tumor markers. Although TACE was planned again, Atezo + Bev was continued while the patient was waiting for hospitalization. After the fifth administration of Atezo + Bev, serum levels of tumor markers decreased to the normal range. Magnetic resonance imaging showed prominently reduced tumor size. Therefore, Atezo + Bev was continued, and after the eighth administration, the CT scan showed the disappearance of all the liver lesions, indicating a complete response. In immunotherapy, the therapeutic response can sometimes be obtained in an atypical pattern due to either an increase in tumor burden or the appearance of new lesions, called “pseudoprogression,” which is rare in HCC.
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Nivolumab对超出进展的转移性肾细胞癌患者的安全性和功效：对随机临床试验的亚组分析。
影响因子：
28.4
作者：
George S;Motzer RJ;Hammers HJ;Redman BG;Kuzel TM;Tykodi SS;Plimack ER;Jiang J;Waxman IM;Rini BI
通讯作者：
Rini BI
影响因子：
1.2
作者：
Shigefuku, Ryuta;Yoshikawa, Kyoko;Tsukimoto, Mone;Owa, Hirono;Tamai, Yasuyuki;Tameda, Masahiko;Ogura, Suguru;Sugimoto, Ryosuke;Tanaka, Hideaki;Eguchi, Akiko;Sugimoto, Kazushi;Hasegawa, Hiroshi;Iwasa, Motoh;Nakagawa, Hayato
通讯作者：
Nakagawa, Hayato
DOI：
10.1016/s1470-2045(17)30074-8
发表时间：
2017-03
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Seymour L;Bogaerts J;Perrone A;Ford R;Schwartz LH;Mandrekar S;Lin NU;Litière S;Dancey J;Chen A;Hodi FS;Therasse P;Hoekstra OS;Shankar LK;Wolchok JD;Ballinger M;Caramella C;de Vries EGE;RECIST working group
通讯作者：
RECIST working group
DOI：
10.1177/23247096211058489
发表时间：
2021-01
影响因子：
1.2
作者：
Watanabe Y;Ogawa M;Tamura Y;Suda S;Kaneko M;Kumagawa M;Hirayama M;Matsumoto N;Yamamoto T;Moriyama M
通讯作者：
Moriyama M
影响因子：
5.1
作者：
Grierson P;Crites D;Ruzinova MB;Yano M;Lim KH
通讯作者：
Lim KH