使用尼妥珠单抗和伊匹单抗治疗转移性纤维肝癌的经验

E. Antonova, I. Dzhanyan, I. V. Savchenko, E. Moroz, K. Laktionov, K. A. Romanova, R. I. Pimenov, Е. V. Sharapova, V. V. Breder
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引用次数: 0

摘要

纤维细胞肝癌是一种罕见的原发性肝肿瘤,没有已知的危险因素,占所有肝细胞癌病例的 1-7%。这种疾病主要发生在青少年身上,偶然发现或在转移过程中已经出现症状。对局部纤维肝细胞癌疗效确切的主要治疗方法是外科手术。放射治疗和经动脉化疗栓塞的经验相互矛盾,需要进一步研究。首选药物抗肿瘤治疗的方案尚不完全明确,寻找有效的治疗方案和针对这种形式肝细胞癌的潜在靶点具有现实意义,需要进一步研究。考虑到该病症的罕见性,世界文献提供了小部分患者的治疗数据以及成功使用多种药物抗肿瘤方案的临床案例。然而,这些数据是相互矛盾的。文献中描述了个别成功使用免疫疗法治疗纤维肝细胞癌患者的临床病例,需要进一步详细研究。我们以这一临床病例为例,说明了联合免疫疗法在纤维小细胞肝癌患者中的长期成功应用。
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Experience with the use of nivolumab and ipilimumab in metastatic fibrolamellar liver carcinoma
Fibrolamellar hepatocellular carcinoma is a rare primary liver tumor with no known risk factors, which occurs in 1–7% of cases of all hepatocellular carcinoma. The disease occurs mainly in adolescents, as an accidental finding or when symptoms appear already during the metastatic process. The main method of treatment with proven efficacy for localized fibrolamellar hepatocellular carcinoma is surgical. The experience of using radiation therapy and transarterial chemoembolization is contradictory and needs additional study. The option of preferred drug antitumor treatment is not fully clear, and the search for effective therapy regimens and potential targets specific to this form of hepatocellular carcinoma is relevant and requires further study. Considering the rarity of the pathology, the world literature presents data on the treatment of small groups of patients and clinical cases of successful use of a number of medicinal antitumor regimens. However, the data are contradictory. The literature describes isolated clinical cases of successful use of immunotherapy in patients with fibrolamellar hepatocellular carcinoma, requiring further detailed study. Using the example of this clinical case, we have shown the successful long-term use of combined immunotherapy in a patient with fibrolamellar liver carcinoma.
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