Consensus interpretation: The combined immune targeting program opens up a new direction for the transformational treatment of advanced hepatocellular carcinoma in my country!

Liver cancer is a high incidence of malignant disease of high mortality of the world and China's annual number of new cases were 90.
6 Million and 37.
0 million, the number of new cases of liver cancer death were as high as 83.
0 Million and 32.
6 Wan
.
Hepatocellular carcinoma(HCC)is the world's highest incidence of liver cancer types, accounting for the total number of primary liver cancer 75.

0% ~ 90.

Liver cancer is a high incidence of malignant disease of high mortality of the world and China's annual number of new cases were 90.

The most important risk factors for HCC are chronic liver disease and cirrhosis.

These two diseases are mainly caused by hepatotropic viruses (such as hepatitis B virus (HBV) and hepatitis C virus)

The most important risk factors for HCC are chronic liver disease and cirrhosis.

The treatment status of advanced hepatocellular carcinoma and the necessity of translational therapy The treatment status of advanced hepatocellular carcinoma and the necessity of translational therapy

At present, the treatment of advanced hepatocellular carcinoma mainly includes local treatment or systemic treatment, such as TAE , TACE , TARE and HAIC, etc.
However, none of the above treatment measures can fundamentally improve the prognosis of patients with advanced hepatocellular carcinoma

.

At present, the treatment of advanced hepatocellular carcinoma mainly includes local treatment or systemic treatment, such as TAE , TACE , TARE and HAIC, etc.

Sorafenib is the first TKIs drug

In addition, there is still controversy about the direct liver resection for patients with advanced hepatocellular carcinoma

The fundamental reason for the poor prognosis of advanced hepatocellular carcinoma lies in the limited oncology benefits of local treatment, systemic therapy or surgical treatment, and none of them can improve the high recurrence rate caused by the severe biological behavior of advanced tumors, and cannot achieve the goal of radical treatment

Exploration of transformational therapy for advanced hepatocellular carcinoma

The connotation of transformational therapy for advanced hepatocellular carcinoma mainly includes the transformation to surgical resectability and the transformation to oncology benefits

.

The connotation of transformational therapy for advanced hepatocellular carcinoma mainly includes the transformation to surgical resectability and the transformation to oncology benefits

Specific measures for transformational treatment of advanced hepatocellular carcinoma include systemic treatment, local treatment and symptomatic treatment

Conversion therapy is preferred for patients with advanced hepatocellular carcinoma, and the corresponding staging is CNLC-IIIa or IIIb and BCLC-C.
Conversion therapy is preferred for patients with advanced hepatocellular carcinoma, and the corresponding staging is CNLC-IIIa or IIIb and BCLC-C.
In the period, after conversion therapy, radical surgery can be applied to patients to obtain long-term survival benefits
.
It is worth noting that in the implementation of translational treatment plan selection, treatment response assessment, operation timing judgment, and postoperative adjuvant treatment, the multidisciplinary diagnosis and treatment team should rely on joint decision-making
.
In the period, after conversion therapy, radical surgery can be applied to patients to obtain long-term survival benefits
.

In recent years, ICIs and AATDs have achieved encouraging results in the treatment of various solid tumors, and are recommended in national guidelines
.
The combined use of ICIs and AATDs is convenient, and the treatment can be completed only in the day ward and at home.
The incidence of serious adverse reactions is low, and most of them can be recovered after stopping the drug or simple hormone therapy, especially the higher objective response rate is expected Greatly improve the success rate of conversion therapy for advanced hepatocellular carcinoma
.
However, it is recommended that TKIs should be stopped before hepatectomy , and ICIs can be stopped at the same time as
AATDs .
To prevent tumor progression, the withdrawal time should not be too long .
After 1 month beginning should continue to give ICIs or ICIs and AATDs treatment 6 ~ 12 months
.
Of course, the combination of ICIs and TKIs has a high surgical conversion rate.
Patients who are effective in treatment can be successfully converted after 3 to 7 cycles of treatment.
pCR and pPROf patients have significant short- term survival benefits after surgery , while patients with pPD have limited survival benefits after surgery
.

In recent years, ICIs and AATDs have achieved encouraging results in the treatment of various solid tumors, and are recommended in national guidelines
.
The combined use of ICIs and AATDs is convenient, and the treatment can be completed only in the day ward and at home.
The incidence of serious adverse reactions is low, and most of them can be recovered after stopping the drug or simple hormone therapy, especially the higher objective response rate is expected Greatly improve the success rate of conversion therapy for advanced hepatocellular carcinoma
.
However, it is recommended that TKIs should be stopped before hepatectomy , and ICIs can be stopped at the same time as
AATDs .
To prevent tumor progression, the withdrawal time should not be too long .
After 1 month beginning should continue to give ICIs or ICIs and AATDs treatment 6 ~ 12 months
.
Of course, the combination of ICIs and TKIs has a high surgical conversion rate.
Patients who are effective in treatment can be successfully converted after 3 to 7 cycles of treatment.
pCR and pPROf patients have significant short- term survival benefits after surgery , while patients with pPD have limited survival benefits after surgery
.

In summary, the population of patients with advanced hepatocellular carcinoma in China is huge, the condition is complex, effective treatment measures are few, and the prognosis is poor.
Improving the treatment effect of advanced hepatocellular carcinoma is an urgent problem that needs to be solved at present
.
The rise of translational therapy has opened up new exploration directions for the treatment of advanced hepatocellular carcinoma
.

In summary, the population of patients with advanced hepatocellular carcinoma in China is huge, the condition is complex, effective treatment measures are few, and the prognosis is poor.
Improving the treatment effect of advanced hepatocellular carcinoma is an urgent problem that needs to be solved at present
.
The rise of translational therapy has opened up new exploration directions for the treatment of advanced hepatocellular carcinoma
.
The population of patients with advanced hepatocellular carcinoma in China is huge, the condition is complex, effective treatment measures are few, and the prognosis is poor.
Improving the treatment effect of advanced hepatocellular carcinoma is an urgent problem that needs to be solved at present
.
The rise of translational therapy has opened up new exploration directions for the treatment of advanced hepatocellular carcinoma
.

Reference

Reference

"Based on advanced hepatocellular carcinoma immunization combined with targeted programs transformed the treatment of China consensus" .
Chinese Journal of Hepatobiliary Surgery .
2021 years 4 Yue .

"Based on advanced hepatocellular carcinoma joint immunization program targeting conversion therapy China consensus" .
Chinese Journal of Hepatobiliary Surgery .
2021 years 4 Yue .
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