ABSTRACT

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.

中文翻译：

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不可切除肝细胞癌中基于一线免疫检查点抑制剂的组合：当前管理和未来挑战

摘要

介绍

免疫疗法最近在医学肿瘤学中发挥了极其重要的作用，作为几种肿瘤类型的一线或后线治疗，并且近年来出现了评估免疫检查点抑制剂 (ICI) 在不可切除的肝细胞癌 (HCC) 中的临床试验.

涵盖的领域

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 加生物治疗的组合作为晚期疾病 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并招募临床试验。

专家意见

对 ICI 单药治疗的研究结果表明，这种策略仅对少数患者有益；相反，最近发表的 IMbrave150 研究报告了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 的总体生存获益。大量临床试验正在评估晚期 HCC 中基于 ICI 的组合，这一策略得到了强大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。