《生命科学》 2022, 34(2): 203-211
免疫检查点抑制剂(immune checkpoint inhibitor, ICI) 是当前晚期肝癌治疗中最有前景的疗法之一。其中，PD-1/PD-L1 抑制剂(Nivolumab、Pembrolizumab 和Camrelizumab) 已先后获批用于晚期肝癌的二线治疗，CTLA-4 抑制剂(Ipilimumab 和Tremelimumab) 在晚期肝癌的临床试验中显示出较好的疗效和安全性。但ICI 单药疗效有限( 患者客观缓解率仅为10%~20%)，为了进一步提高患者的预后，基于ICI 联合治疗的临床研究陆续开展。ICI 与抗血管药联合(Atezolizumab + Bevacizumab，Pembrolizumab + Lenvatinib 和Camrelizumab + Apatinib) 已获批用于晚期肝癌一线治疗。此外，与ICI 单药相比，ICI 单药间联合，ICI 与放、化疗等治疗方式的联合能够更好地控制肿瘤进展，并有效延长患者的生存期。但ICI 治疗仍存在副作用和疗效难以预测、肿瘤超进展等问题。新一代的ICI ( 靶向Tim-3、LAG-3 和TIGIT) 能否有效治疗晚期HCC仍有待探索。
通讯作者：刘爱群 , Email:Liuaiqun_2004@163.com
Immune checkpoint inhibitor (ICI) is one of the most promising therapies in the treatment of advanced liver cancer. Among them, PD-1 / PD-L1 inhibitors (Nivolumab, Pembrolizumab and Camrelizumab) have been successively approved for the second-line treatment of advanced liver cancer. CTLA-4 inhibitors (Ipilimumab and Tremelimumab) have shown good efficacy and safety in clinical trials of advanced liver cancer. However, the efficacy of ICI monotherapy is limited (the objective remission rate of patients is only 10%-20%). In order to further improve the prognosis of patients, clinical studies based on ICI combined therapy have been carried out one after another. The combination of ICI and antivascular drugs (Atezolizumab + Bevacizumab, Pembrolizumab +Lenvatinib and Camrelizumab + Apatinib) has been approved for the first-line treatment of advanced liver cancer. In addition, compared with ICI single drug, ICI single drug combination, ICI combined with radiotherapy and chemotherapy and other treatment methods can better control tumor progression and effectively prolong the survival of patients. However, ICI treatment still has problems such as unpredictable side effects and curative effects, and super-progressive tumors. Whether the new generation of ICI (targeting Tim-3, LAG-3 and TIGIT) can effectively treat advanced HCC remains to be explored.
Communication Author：LIU Ai-Qun , Email:Liuaiqun_2004@163.com