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肝细胞癌的系统治疗:基于中国共识的多学科专家声明

Systemic Therapy for Hepatocellular Carcinoma: Chinese Consensus-Based Interdisciplinary Expert Statements.

作者信息

Sun Yongkun, Zhang Wen, Bi Xinyu, Yang Zhengqiang, Tang Yu, Jiang Liming, Bi Feng, Chen Minshan, Cheng Shuqun, Chi Yihebali, Han Yue, Huang Jing, Huang Zhen, Ji Yuan, Jia Liqun, Jiang Zhichao, Jin Jing, Jin Zhengyu, Li Xiao, Li Zhiyu, Liang Jun, Liu Lianxin, Liu Yunpeng, Lu Yinying, Lu Shichun, Meng Qinghua, Niu Zuoxing, Pan Hongming, Qin Shukui, Qu Wang, Shao Guoliang, Shen Feng, Song Tianqiang, Song Yan, Tao Kaishan, Tian Aiping, Wang Jianhua, Wang Wenling, Wang Zhe, Wu Liqun, Xia Feng, Xing Baocai, Xu Jianming, Xue Huadan, Yan Dong, Yang Lin, Ying Jianming, Yun Jingping, Zeng Zhaochong, Zhang Xuewen, Zhang Yanqiao, Zhang Yefan, Zhao Jianjun, Zhou Jianguo, Zhu Xu, Zou Yinghua, Dong Jiahong, Fan Jia, Lau Wan Yee, Sun Yan, Yu Jinming, Zhao Hong, Zhou Aiping, Cai Jianqiang

机构信息

Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Liver Cancer. 2022 Jan 4;11(3):192-208. doi: 10.1159/000521596. eCollection 2022 Jun.

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is the most common type of liver cancer and causes many cancer-related deaths worldwide; in China, it is the second most prevalent cause of cancer deaths. Most patients are diagnosed clinically with advanced stage disease.

SUMMARY

For more than a decade, sorafenib, a small-molecular-weight tyrosine kinase inhibitor (SMW-TKI) was the only molecular targeted drug available with a survival benefit for the treatment of advanced HCC. With the development of novel TKIs and immune checkpoint inhibitors for advanced HCC, the management of patients has been greatly improved. However, though angiogenic-based targeted therapy remains the backbone for the systemic treatment of HCC, to date, no Chinese guidelines for novel molecular targeted therapies to treat advanced HCC have been established. Our interdisciplinary panel on the treatment of advanced HCC comprising hepatologists, hepatobiliary surgeons, oncologists, radiologists, pathologists, orthopedic surgeons, traditional Chinese medicine physicians, and interventional radiologists has reviewed the literature in order to develop updated treatment regimens.

KEY MESSAGES

Panel consensus statements for the appropriate use of new molecular -targeted drugs including doses, combination therapies, adverse reaction management as well as efficacy evaluation, and predictions for treatment of advanced HCC with evidence levels based on published data are presented, thereby providing an overview of molecular targeted therapies for healthcare professionals.

摘要

背景

肝细胞癌(HCC)是最常见的肝癌类型,在全球导致许多与癌症相关的死亡;在中国,它是癌症死亡的第二大常见原因。大多数患者在临床诊断时已处于疾病晚期。

总结

十多年来,索拉非尼,一种小分子酪氨酸激酶抑制剂(SMW-TKI),是唯一一种对晚期HCC治疗具有生存获益的分子靶向药物。随着用于晚期HCC的新型酪氨酸激酶抑制剂(TKIs)和免疫检查点抑制剂的发展,患者的管理得到了极大改善。然而,尽管基于血管生成的靶向治疗仍然是HCC全身治疗的支柱,但迄今为止,尚未制定中国治疗晚期HCC的新型分子靶向治疗指南。我们由肝病学家、肝胆外科医生、肿瘤学家、放射科医生、病理学家、骨科医生、中医医生和介入放射科医生组成的晚期HCC治疗跨学科小组对文献进行了综述,以制定更新的治疗方案。

关键信息

给出了关于合理使用新分子靶向药物的小组共识声明,包括剂量、联合治疗、不良反应管理以及疗效评估,并根据已发表的数据对晚期HCC治疗的证据水平进行了预测,从而为医疗专业人员提供分子靶向治疗的概述。

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