Drug co-administration in the HCC tumor immune microenvironment

Yingying Shao, Ranran Su, Yu Wang, Shuangshuang Yin, Wei-Ling Pu, S. Koo, Haiyang Yu
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Abstract

The etiology and exact molecular mechanisms of primary hepatocellular carcinoma (HCC) remain unclear, and its incidence has continued to increase in recent years. Despite tremendous advances in systemic therapies such as molecularly targeted drugs, HCC has some of the worst prognoses owing to drug resistance, frequent recurrence, and metastasis. Hepatocellular carcinoma is a widespread disease and its progression is regulated by the immune system. Traditional Chinese medicine (TCM) has been gradually theorized and systematized to have a holistic regulatory role for use in the prevention and treatment of tumors. Although half of the patients with HCC receive systemic therapy, traditionally Sorafenib or Lenvatinib are used as first-line treatment modalities. Traditional Chinese Medicine is also widely used in the treatment of HCC, the same immune checkpoint inhibitors (ICIs) such as PD-L1 have also received much focus in the field of continuously changing cancer treatment. Owing to the high probability of resistance to specific drugs and unsatisfactory efficacy due to administration of chemotherapy in single doses, the combination of drugs is the newest therapeutic option for patients with tumors and has become increasingly prominent for treatment. In this paper, the research progress on combination therapy in the immunology of HCC is reviewed and the unique advantages of synergistic antitumor therapy with combination drugs are highlighted to provide new solutions for the clinical treatment of tumors.
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HCC肿瘤免疫微环境中药物共给药的研究
原发性肝细胞癌(HCC)的病因和确切的分子机制尚不清楚,近年来其发病率持续上升。尽管在分子靶向药物等全身治疗方面取得了巨大进步,但HCC由于耐药、频繁复发和转移而预后最差。肝细胞癌是一种广泛存在的疾病,其进展受免疫系统的调节。中医药已逐步理论化和系统化,在肿瘤防治中具有整体调控作用。虽然一半的HCC患者接受全身治疗,但传统上索拉非尼或Lenvatinib被用作一线治疗方式。中医药也广泛应用于HCC的治疗,同样的免疫检查点抑制剂(ici)如PD-L1也在不断变化的癌症治疗领域受到关注。由于对特定药物的耐药概率高,单剂量化疗效果不理想,药物联合治疗是肿瘤患者最新的治疗选择,在治疗中日益突出。本文综述了HCC免疫学领域联合治疗的研究进展,强调联合药物协同抗肿瘤治疗的独特优势,为临床肿瘤治疗提供新的解决方案。
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