First-line immune checkpoint inhibitor-based combinations in unresectable hepatocellular carcinoma: current management and future challenges
First-line immune checkpoint inhibitor-based combinations in unresectable hepatocellular carcinoma: current management and future challenges
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DOI：
10.1080/17474124.2021.1973431
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发表时间：
2021-09-02
影响因子：
3.9
通讯作者：
Brandi, Giovanni
中科院分区：
文献类型：
--
作者：
Rizzo, Alessandro;Ricci, Angela Dalia;Brandi, Giovanni
简介 免疫疗法最近在肿瘤内科中发挥着极其重要的作用，作为多种肿瘤类型的一线或后期治疗，近年来出现了评估免疫检查点抑制剂 (ICIs) 对不可切除的肝细胞癌 (HCC) 的临床试验。在此，我们概述了最近发表的研究，探索双重免疫检查点阻断或 ICI 与生物治疗相结合作为晚期 HCC 患者的一线治疗，特别关注这些治疗策略背后的生物学原理，以及正在进行的积极和招募的临床试验。专家意见 ICI 单一疗法的研究结果表明，这种策略仅对少数患者有益；相反，最近发表的 IMbrave150 研究报告称，与索拉非尼作为一线治疗相比，接受阿特珠单抗加贝伐单抗联合治疗的 HCC 患者的总体生存期获益。大量临床试验正在评估基于 ICI 的组合治疗晚期 HCC，这一策略得到了可靠的临床前和早期临床数据的支持，这些研究的结果备受期待。
Introduction Immunotherapy has recently taken on an extremely important role in medical oncology, as first- or later-line treatment in several tumor types, and recent years have seen the emerging of clinical trials assessing immune checkpoint inhibitors (ICIs) in unresectable hepatocellular carcinoma (HCC). Areas Covered Herein, we provide an overview of recently published studies exploring the dual immune checkpoint blockade or the combination of ICIs plus biological treatments as first-line treatment in HCC patients with advanced disease, especially focusing on the biological rationale behind these therapeutic strategies, and ongoing active and recruiting clinical trials. Expert Opinion Results of studies on monotherapy with ICIs have suggested that this strategy could be beneficial only in a minority of patients; conversely, the recently published IMbrave150 study has reported an overall survival benefit in HCC receiving the combination of atezolizumab plus bevacizumab compared to sorafenib as first-line treatment. A wide number of clinical trials is evaluating ICI-based combinations in advanced HCC, a strategy which is supported by robust preclinical and early-phase clinical data, and results of these studies are highly awaited.