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引用次数: 0
摘要
背景：在标准的一线免疫检查点抑制剂(ICI)/抗血管生成治疗和二线酪氨酸激酶抑制剂（TKIs）治疗后进展的晚期HCC治疗选择有限。病例介绍：一名67岁男性hbv相关HCC （cT2N1M0, Child-Pugh B）在经动脉化疗栓塞、贝伐单抗/辛替单抗和lenvatinib单药治疗后表现出快速进展。贝伐单抗（400mg IV q3w）、辛替单抗（200mg IV q3w）和lenvatinib （8mg每日）的挽救性三联疗法在两个周期内实现了50%的甲胎蛋白（AFP）降低，并持续10个月的放射学疾病稳定，只有1级疲劳和咯血。结论：这是首次有文献记载的贝伐单抗/辛替单抗/lenvatinib三联药治疗三级难治性HCC的疗效，提示Child-Pugh B患者也可能存在协同作用机制和可行性。这些发现值得在前瞻性研究中进一步调查。
Durable Control of Multi-Refractory HBV-HCC with Bevacizumab/Sintilimab/Lenvatinib Triplet Therapy.
Background: Advanced HCC progressing after standard first-line immune checkpoint inhibitor (ICI)/antiangiogenic therapy and second-line tyrosine kinase inhibitors (TKIs) has limited treatment options.
Case presentation: A 67-year-old male with HBV-related HCC (cT2N1M0, Child-Pugh B) exhibited rapid progression after transarterial chemoembolization, bevacizumab/sintilimab, and lenvatinib monotherapy. Salvage triplet therapy with bevacizumab (400 mg IV q3w), sintilimab (200 mg IV q3w), and lenvatinib (8 mg daily) achieved >50% alpha-fetoprotein (AFP) reduction within two cycles and sustained radiologic disease stabilization for 10 months, with only grade 1 fatigue and hemoptysis.
Conclusion: This is the first documented case of bevacizumab/sintilimab/lenvatinib triplet efficacy in triple-class refractory HCC, suggesting potential synergistic mechanisms and feasibility even in Child-Pugh B patients. These findings warrant further investigation in prospective studies.
期刊介绍：
Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include:
◦Epidemiology, detection and screening
◦Cellular research and biomarkers
◦Identification of biotargets and agents with novel mechanisms of action
◦Optimal clinical use of existing anticancer agents, including combination therapies
◦Radiation and surgery
◦Palliative care
◦Patient adherence, quality of life, satisfaction
The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.
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