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中华普通外科学文献(电子版) ›› 2024, Vol. 18 ›› Issue (06) : 457 -463. doi: 10.3877/cma.j.issn.1674-0793.2024.06.013

综述

FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展
高俊颖1,2, 张海洲2, 区泓乐1,2, 孙强1,2,()   
  1. 1.524002 湛江,广东医科大学第一临床医学院
    2.528400 中山市人民医院普外一科(肝胆外科)
  • 收稿日期:2024-05-20 出版日期:2024-12-01
  • 通信作者: 孙强

Progress in the application of FOLFOX-HAIC-based adjuvant translational therapy for hepatocellular carcinoma

Junying Gao1,2, Haizhou Zhang2, Hongle Qu1,2, Qiang Sun1,2,()   

  1. 1.The First Clinical Medical College of Guangdong Medical University, Zhanjiang 524002, China
    2.The First Department of General Surgery(Hepatobiliary Surgery), Zhongshan City People's Hospital, Zhongshan 528400, China
  • Received:2024-05-20 Published:2024-12-01
  • Corresponding author: Qiang Sun
引用本文:

高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.

Junying Gao, Haizhou Zhang, Hongle Qu, Qiang Sun. Progress in the application of FOLFOX-HAIC-based adjuvant translational therapy for hepatocellular carcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(06): 457-463.

原发性肝癌是我国最常见的恶性肿瘤之一。手术切除是使肝癌患者获得长期生存乃至治愈的重要手段,但术后复发率高,多数患者初诊时已处于中晚期,不适合手术切除,如何改善肝癌患者预后成了亟待解决的难题。近年来,FOLFOX 方案的肝动脉灌注化疗(FOLFOX-HAIC)为基础的肝癌转化治疗及新辅助治疗提高了肝癌患者的生存获益。为厘清FOLFOX-HAIC 为基础的肝细胞癌转化治疗与新辅助治疗的作用,本文将对FOLFOX-HAIC 为基础的肝细胞癌术前治疗的应用及研究进展进行综述,并探讨FOLFOX-HAIC 为基础的肝细胞癌新辅助治疗的潜在优势。

Primary liver cancer is one of the most common malignant tumours in China. Surgical resection is important to achieve long-term survival and even cure for liver cancer patients, but the postoperative recurrence rate is high. Most of the patients are already in the middle or late stage at the time of initial diagnosis and are not suitable for surgical resection, so how to improve the prognosis of liver cancer patients has become a difficult problem that needs to be solved urgently. In recent years, FOLFOX regimen of hepatic arterial infusion chemotherapy (FOLFOX-HAIC)-based conversion and neoadjuvant therapy for hepatocellular carcinoma has improved the survival benefit of hepatocellular carcinoma patients. To clarify the roles of FOLFOX-HAIC-based conversion therapy and neoadjuvant therapy for hepatocellular carcinoma, this article provides a systematic review of the application and research progress of FOLFOXHAIC-based preoperative therapy for hepatocellular carcinoma and discusses the potential advantages of FOLFOX-HAIC-based neoadjuvant therapy for hepatocellular carcinoma.

[1]
Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[2]
国家卫生健康委员会. 原发性肝癌诊疗指南(2022 年版)[J/OL]. 中华普通外科学文献(电子版), 2022, 16(2): 81-96.
[3]
夏永祥, 张峰, 李相成, 等. 原发性肝癌 10 966 例外科治疗分析[J]. 中华外科杂志, 2021, 71(1): 6-17.
[4]
朱小东, 周俭. 原发性肝癌新辅助治疗的共识与争议[J]. 中国实用外科杂志, 2023, 43(3): 286-290, 309.
[5]
Heimbach JK, Kulik LM, Finn RS, et al. AASLD guidelines for the treatment of hepatocellular carcinoma[J]. Hepatology, 2018, 67(1):358-380.
[6]
Kudo M, Kawamura Y, Hasegawa K, et al. Management of hepatocellular carcinoma in Japan: JSH Consensus Statements and Recommendations 2021 Update[J]. Liver Cancer, 2021, 10(3):181-223.
[7]
陈敏山, 元云飞, 郭荣平, 等. 肝动脉灌注化疗在肝癌转化治疗中的应用——中山大学肿瘤防治中心的经验总结[J/OL]. 中国医学前沿杂志(电子版), 2021, 13(3): 70-76.
[8]
He MK, Le Y, Li QJ, et al. Hepatic artery infusion chemotherapy using mFOLFOX versus transarterial chemoembolization for massive unresectable hepatocellular carcinoma: A prospective non-randomized study[J]. Chin J Cancer, 2017, 36(1): 83.
[9]
肝癌新辅助治疗中国专家共识协作组, 中国研究型医院学会消化外科专业委员会, 中国抗癌协会肝癌专业委员会. 肝癌新辅助治疗中国专家共识(2023 版)[J]. 中华外科杂志, 2023,73(12): 1035-1045.
[10]
曾永毅, 林孔英, 陈清静. 肝细胞癌转化和新辅助治疗的进展与挑战[J]. 中华消化外科杂志, 2023, 22(2): 195-201.
[11]
孙惠川, 谢青, 荚卫东, 等. 肝癌转化治疗中国专家共识(2021版)[J]. 中国实用外科杂志, 2021, 41(6): 618-632.
[12]
Liu H, Qin X, Jiang H, et al. Comparison of hepatic arterial infusion chemotherapy and transarterial chemoembolization for advanced hepatocellular carcinoma: A systematic review and meta-analysis[J]. J Gastrointestin Liver Dis, 2022, 31(3): 336-343.
[13]
Qi X, Liu L, Wang D, et al. Hepatic resection alone versus in combination with pre- and post-operative transarterial chemoembolization for the treatment of hepatocellular carcinoma:A systematic review and meta-analysis[J]. Oncotarget, 2015, 6(34):36838-36859.
[14]
Li QJ, He MK, Chen HW, et al. Hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin versus transarterial chemoembolization for large hepatocellular carcinoma: A randomized phase Ⅲ trial[J]. J Clin Oncol, 2022, 40(2): 150-160.
[15]
Deng M, Cai H, He B, et al. Hepatic arterial infusion chemotherapy versus transarterial chemoembolization, potential conversion therapies for single huge hepatocellular carcinoma: A retrospective comparison study[J]. Int J Surg, 2023, 109(11): 3303-3311.
[16]
Wang J, Zheng Z, Wu T, et al. Hepatic arterial infusion chemotherapy as a timing strategy for conversion surgery to treat hepatocellular carcinoma: A single-center real-world study[J]. J Hepatocell Carcinoma, 2022, 9: 999-1010.
[17]
Liu BJ, Gao S, Zhu X, et al. Real-world study of hepatic artery infusion chemotherapy combined with anti-PD-1 immunotherapy and tyrosine kinase inhibitors for advanced hepatocellular carcinoma[J]. Immunotherapy, 2021, 13(17): 1395-1405.
[18]
Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of Sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: A phase randomised, double-blind, placebo-controlled trial[J]. Lancet Oncol, 2009, 10(1): 25-34.
[19]
Long Y, Song X, Guan Y, et al. Sorafenib plus hepatic arterial infusion chemotherapy versus sorafenib alone for advanced hepatocellular carcinoma: A systematic review and metaanalysis[J]. J Gastroenterol Hepatol, 2023, 38(4): 486-495.
[20]
Moriya K, Nagamatsu S, Uejima M, et al. Increasing evidence for the efficacy of hepatic arterial infusion chemotherapy combined with systemic therapy for advanced hepatocellular carcinoma with macrovascular invasion: time to consider a more effective approach[J]. J Gastrointest Oncol, 2023, 14(5): 2282-2286.
[21]
Ikeda M, Yamashita T, Ogasawara S, et al. Multicenter phaseⅡ trial of lenvatinib plus hepatic intra-arterial infusion chemotherapy with cisplatin for advanced hepatocellular carcinoma: LEOPARD[J]. Liver Cancer, 2023, 13(2): 193-202.
[22]
He MK, Li QJ, Zou RH, et al. Sorafenib plus hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin vs sorafenib alone for hepatocellular carcinoma with portal vein invasion[J].JAMA Oncol, 2019, 5(7): 953-960 .
[23]
Chen CT, Liu TH, Shao YY, et al. Revisiting hepatic artery infusion chemotherapy in the treatment of advanced hepatocellular carcinoma[J].Int J Mol Sci, 2021, 22(23): 12880.
[24]
El-Khoueiry AB, Sangro B, Yau T, et al. Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): An open-label, non-comparative, phase 1/2 dose escalation and expansion trial[J]. Lancet, 2017, 389(10088): 2492-2502.
[25]
Yau T, Hsu C, Kim TY, et al. Nivolumab in advanced hepatocellular carcinoma: sorafenib-experienced Asian cohort analysis[J]. J Hepatol, 2019, 71(3): 543-552.
[26]
Finn RS, Ryoo BY, Merle P, et al. Pembrolizumab as second-line therapy in patients with advanced hepatocellular carcinoma in KEYNOTE-240: A randomized, double-blind, phase Ⅲ trial[J]. J Clin Oncol, 2020, 38(3): 193-202.
[27]
Mei J, Li SH, Li QJ, et al. Anti-PD-1 immunotherapy improves the efficacy of hepatic artery infusion chemotherapy in advanced hepatocellular carcinoma[J]. J Hepatocell Carcinoma, 2021, 8:167-176.
[28]
Li Y, Liu W, Chen J, et al. Efficiency and safety of hepatic arterial infusion chemotherapy (HAIC) combined with anti-PD1 therapy versus HAIC monotherapy for advanced hepatocellular carcinoma:A multicenter propensity score matching analysis[J]. Cancer Med,2024, 13(1): e6836.
[29]
Li Z, Xu Y, Qu W, et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with immune checkpoint inhibitors and tyrosine kinase inhibitors in advanced hepatocellular carcinoma: A systematic review and meta-analysis[J]. Oncol Lett,2023, 26(6): 534.
[30]
He MK, Liang RB, Zhao Y, et al. Lenvatinib, toripalimab, plus hepatic arterial infusion chemotherapy versus lenvatinib alone for advanced hepatocellular carcinoma[J]. Ther Adv Med Oncol, 2021,13: 17588359211002720.
[31]
Chen S, Shi F, Wu ZQ, et al. Hepatic arterial infusion chemotherapy plus lenvatinib and tislelizumab with or without transhepatic arterial embolization for unresectable hepatocellular carcinoma with portal vein tumor thrombus and high tumor burden:A multicenter retrospective study[J]. J Hepatocell Carcinoma,2023, 10: 1209-1222.
[32]
Zhang TQ, Geng ZJ, Zuo MX, et al. Camrelizumab (a PD-1 inhibitor) plus apatinib (an VEGFR-2 inhibitor) and hepatic artery infusion chemotherapy for hepatocellular carcinoma in Barcelona Clinic Liver Cancer stage C (TRIPLET): A phase study[J]. Signal Transduct Target Ther, 2023, 8(1): 413.
[33]
Yu BR, Zhang N, Feng Y, et al. Hepatectomy after conversion therapy with hepatic arterial infusion chemotherapy, tyrosine kinase inhibitors and anti-PD-1 antibodies for initially unresectable hepatocellular carcinoma[J]. J Hepatocellular Carcinoma, 2023,10: 1709-1721.
[34]
Gao S, Zhang PJ, Guo JH, et al. Chemoembolization alone vs combined chemoembolization and hepatic arterial infusion chemotherapy in inoperable hepatocellular carcinoma patients[J].World J Gastroenterol, 2015, 21(36): 10443-10452.
[35]
Liu BJ, Gao S, Zhu X, et al. Combination therapy of chemoembolization and hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis compared with chemoembolization alone: A propensity scorematched analysis[J]. Biomed Res Int, 2021, 2021: 6670367.
[36]
Li S, Zhong C, Li Q, et al. Neoadjuvant transarterial infusion chemotherapy with FOLFOX could improve outcomes of resectable BCLC stage A/B hepatocellular carcinoma patients beyond Milan criteria: An interim analysis of a multi-center, phase 3,randomized, controlled clinical trial[J]. J Clin Oncol, 2021, 39(15_suppl): 4008.
[37]
Hu ZL, Yang ZY, Pan YX, et al. Survival benefit of preoperative hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin followed by hepatectomy for hepatocellular carcinoma[J]. Front Pharmacol, 2023, 14: 1210835.
[38]
赵明, 伍家鸣, 商昌珍, 等. 肝癌转化治疗相关技术方法及评价[J]. 中国实用外科杂志, 2021, 41(3): 262-268.
[39]
Goto Y, Hisaka T, Sakai H, et al. Salvage surgery for initially unresectable locally advanced hepatocellular carcinoma downstaged by hepatic arterial infusion chemotherapy[J].Anticancer Res, 2020, 40(8): 4773-4777.
[40]
Li S, Xu J, Zhang H, et al. The role of hepatic arterial infusion chemotherapy in the treatment of hepatocellular carcinoma: A systematic review and meta-analysis[J]. Chemotherapy, 2021,66(4): 124-133.
[41]
Liu TH, Hsu CH, Shao YY. Successful hepatic arterial infusion of chemotherapy in a patient with advanced hepatocellular carcinoma and impending liver failure[J]. Liver Cancer, 2018, 7(2): 205-208.
[42]
Hu J, Bao Q, Cao G, et al. Hepatic arterial infusion chemotherapy using oxaliplatin plus 5-fluorouracil versus transarterial chemoembolization/embolization for the treatment of advanced hepatocellular carcinoma with major portal vein tumor thrombosis[J]. Cardiovasc Intervent Radiol, 2020, 43(7): 996-1005.
[43]
Terashima T, Yamashita T, Arai K, et al. Beneficial effect of maintaining hepatic reserve during chemotherapy on the outcomes of patients with hepatocellular carcinoma[J]. Liver Cancer, 2017,6(3): 236-249.
[44]
任秋洋, 李淑文, 杨世忠. 肝细胞癌新辅助治疗的进展和热点[J/OL]. 中国医学前沿杂志(电子版), 2023, 15(5): 69-75.
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