移植肿瘤学时代的免疫疗法和肝脏移植最新动态

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Maen Abdelrahim, Abdullah Esmail, Taizo Hibi, Vincenzo Mazzaferro
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引用次数: 0

摘要

移植肿瘤学是一个不断扩展的癌症治疗领域,它特别强调将肝移植(LT)作为可控制但无法切除的肿瘤患者的首选治疗方法。在所有原发性肝癌中,绝大多数都被确定为肝细胞癌(HCC)或胆管癌(CCA),它们被归类为侵袭性极强的恶性肿瘤,在发展到晚期之前常常没有症状,因此切除等根治性手术并不可行。因此,越来越多的患者在手术前接受新辅助治疗,并取得了良好的疗效。尽管这种治疗方式促使人们进一步研究免疫检查点抑制剂(ICPIs)作为独立治疗方法以及与局部区域治疗(LRTs)联合使用的疗效,以帮助更多患者获得治愈资格。通过这种多学科方法和治疗规划,免疫治疗方案和联合治疗的多项试验取得了成功,为通过降期和 "桥接 "以前不符合严格的LT标准的患者来提高治疗资格奠定了基础。LT后的监测是移植肿瘤学的重要组成部分。循环肿瘤 DNA(ctDNA)的出现为在早期阶段识别癌症复发提供了一种新方法。最近的研究重点是液体活检,这是一种能有效识别癌症动态的技术。这是另一项创新,显示了移植肿瘤学的快速发展速度,让人感到护理重点无所适从。治疗方式在不断发展,但当一个领域变化如此之快时,必须根据数据和患者的需求重新定位。在这篇评论中,我们将对新辅助治疗中ICPIs的最新应用以及LT术后随访监测中液体活检的最新应用进行反思。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Focal Update on Immunotherapy and Liver Transplantation in the Era of Transplant Oncology
Transplant oncology is an expanding area of cancer therapy that specifically emphasizes the use of liver transplantation (LT) as the preferred treatment for patients with manageable, but unresectable, tumors. The management and optimization of overall survival strategies, accompanied by an arguably decent quality of life, have been at the forefront of liver oncology treatment, as a plurality of all primary liver cancers are identified as either hepatocellular carcinoma (HCC) or cholangiocarcinoma (CCA), which are classified as highly aggressive malignancies and frequently remain asymptomatic until they progress to advanced stages, rendering curative procedures, such as resection, impractical. This has led to an increase in utilization of neoadjuvant interventions conducted prior to surgery, which has yielded favorable outcomes. Though this treatment modality has prompted further investigations into the efficacy of immune checkpoint inhibitors (ICPIs) as standalone treatments and in combination with locoregional treatments (LRTs) to bridge more patients into curative eligibility. This multidisciplinary methodology and treatment planning has seen multiple successful trials of immunotherapy regimes and combinate treatments, setting the groundwork for increasing eligibility through downstaging and “bridging” previously ineligible patients within stringent LT criteria. Surveillance after LT is a crucial component of transplant oncology. The emergence of circulating tumor DNA (ctDNA) has provided a novel approach to identifying the recurrence of cancer in its early stages. Recent research has focused on liquid biopsy, a technique that effectively identifies the dynamics of cancer. This is another innovation to demonstrate the rate at which transplant oncology is rapidly advancing, making the focus of care feel disorienting. Modalities of care are constantly evolving, but when a field is changing as rapidly as this one, it is imperative to reorient to the data and the needs of the patients. In this commentary, we reflect on the update’s utilization of ICPIs in neoadjuvant settings as well as the updates on the utilization of liquid biopsy in post-LT follow-up surveillance.
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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