- 期刊
肝細胞癌免疫治療發展與應用
Advances and Applications of Immunotherapy for Hepatocellular Carcinoma
摘要
肝細胞癌（hepatocellular carcinoma, HCC）是全球極常見且死亡率極高的惡性腫瘤之一。它的形成因素複雜且和多項病因有關，而這些因素導致原致癌基因及抑癌基因之間失衡，最終引發癌症。HCC最常發生於肝硬化晚期，常因發現太晚而導致預後不佳。臨床上在選擇治療方法時，常考量以最低劑量藥物使用達成最大臨床治療效果，但對於全身性常用細胞毒性藥物治療（即傳統化療，如cisplatin、fluorouracil⋯⋯等）治療效果不顯著且易有感染、出血等併發症。而近來免疫治療在多項癌症的臨床治療頗具成果，它可干擾致癌相關分子以抑制腫瘤細胞生長，比細胞毒性化療更具選擇性和特異性。目前晚期HCC使用免疫治療相關藥物已有多項臨床試驗結果，且仍在進行。本文彙整HCC臨床試驗免疫治療及其相關HCC進展分子機制，期望更加瞭解HCC免疫治療發展與應用，為後續針對HCC治療設計有效方案作為參考運用。
並列摘要
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with a high mortality rate in the world. The formation factors of HCC are complex and related to multiple etiologies, resulting in an imbalance between proto-oncogenes and tumor suppressor genes. Moreover, HCC often occurs in the end-stage of liver cirrhosis, and the prognosis is poor due to late diagnosis. Under the condition that the lowest dose of drugs is used to achieve the highest clinical therapeutic effect, systemic commonly used cytotoxic drug treatments are often ineffective and induce complications such as infection and bleeding (i.e. traditional chemotherapy, such as cisplatin, 5-FU, etc). Recently, the application of immunotherapy in the clinical treatment of several cancers has achieved considerable results, and it is also effective in the treatment of liver cancer. It is more selective and specific than cytotoxic chemotherapy to inhibit the growth of tumor cells by interfering with molecules related to carcinogenesis. Many clinical trial results and is still in progress by using immunotherapy in the treatment of terminal HCC at present. This article summarizes HCC clinical trials of immunotherapy and its related molecular mechanisms of HCC progression, in order to better understand the development and application of HCC immunotherapy, and to design effective strategies for subsequent HCC treatment as a reference.