New insights into mechanisms and interventions of locoregional therapies for hepatocellular carcinoma.

IF 7 2区 医学 Q1 ONCOLOGY Chinese Journal of Cancer Research Pub Date : 2024-04-30 DOI:10.21147/j.issn.1000-9604.2024.02.06
Hanyuan Liu, Chunmei Wang, Ruiqiang Wang, Hengsong Cao, Yongfang Cao, Tian Huang, Zhengqing Lu, Hua Xiao, Mengcheng Hu, Hanjin Wang, Jun Zhao
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Abstract

Hepatocellular carcinoma (HCC) is responsible for a significant number of cancer-related deaths worldwide and its incidence is increasing. Locoregional treatments, which are precision procedures guided by imaging to specifically target liver tumors, play a critical role in the management of a substantial portion of HCC cases. These therapies have become an essential element of the HCC treatment landscape, with transarterial chemoembolization (TACE) being the treatment of choice for patients with intermediate to advanced stages of the disease. Other locoregional therapies, like radiofrequency ablation, are highly effective for small, early-stage HCC. Nevertheless, the advent of targeted immunotherapy has challenged these established treatments. Tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) have shown remarkable efficacy in clinical settings. However, their specific uses and the development of resistance in subsequent treatments have led clinicians to reevaluate the future direction of HCC therapy. This review concentrates on the distinct features of both systemic and novel locoregional therapies. We investigate their effects on the tumor microenvironment at the molecular level and discuss how targeted immunotherapy can be effectively integrated with locoregional therapies. We also examine research findings from retrospective studies and randomized controlled trials on various combined treatment regimens, assessing their validity to determine the future evolution of locoregional therapies within the framework of personalized, comprehensive treatment.

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对肝细胞癌局部治疗机制和干预措施的新认识。
肝细胞癌(HCC)是造成全球大量癌症相关死亡的原因,而且其发病率还在不断上升。局部治疗是一种通过成像引导、专门针对肝脏肿瘤的精确手术,在相当一部分 HCC 病例的治疗中发挥着至关重要的作用。经动脉化疗栓塞术(TACE)是中晚期患者的首选治疗方法。其他局部疗法,如射频消融术,对早期小规模的 HCC 非常有效。然而,靶向免疫疗法的出现对这些既有疗法提出了挑战。酪氨酸激酶抑制剂(TKIs)和免疫检查点抑制剂(ICIs)已在临床中显示出显著疗效。然而,这些药物的特殊用途以及后续治疗中耐药性的产生促使临床医生重新评估 HCC 治疗的未来方向。本综述将集中讨论全身性疗法和新型局部疗法的不同特点。我们研究了它们在分子水平上对肿瘤微环境的影响,并讨论了靶向免疫疗法如何与局部治疗有效结合。我们还考察了各种联合治疗方案的回顾性研究和随机对照试验的研究成果,评估其有效性,以确定局部区域疗法在个性化综合治疗框架内的未来发展。
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来源期刊
自引率
9.80%
发文量
1726
审稿时长
4.5 months
期刊介绍: Chinese Journal of Cancer Research (CJCR; Print ISSN: 1000-9604; Online ISSN:1993-0631) is published by AME Publishing Company in association with Chinese Anti-Cancer Association.It was launched in March 1995 as a quarterly publication and is now published bi-monthly since February 2013. CJCR is published bi-monthly in English, and is an international journal devoted to the life sciences and medical sciences. It publishes peer-reviewed original articles of basic investigations and clinical observations, reviews and brief communications providing a forum for the recent experimental and clinical advances in cancer research. This journal is indexed in Science Citation Index Expanded (SCIE), PubMed/PubMed Central (PMC), Scopus, SciSearch, Chemistry Abstracts (CA), the Excerpta Medica/EMBASE, Chinainfo, CNKI, CSCI, etc.
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