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APASL:肝细胞癌的全身治疗临床实践指南(2024)

制定者:
亚太肝脏研究学会(APASL,Asian-Pacific Association for the Study of the Liver)

2024年11月20日

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摘要:

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In Asia-Pacific region, hepatocellular carcinoma is a serious health threat attributing to over 600,000 deaths each year and account for over 70% of global cases. Clinically, the major unmet needs are recurrence after curative-intent surgery, liver transplantation or local ablation and disease progression in those with hepatocellular carcinoma not eligible for resection or failed locoregional therapy. In the recent few years, new targeted therapy and immune-checkpoint inhibitors have been registered as systemic therapy to address these issues. Notably, new forms of systemic therapy, either as first-line or second-line therapy for unresectable hepatocellular or those not eligible for locoregional therapy, are now available. New data is also emerging with the use of systemic therapy to prevent hepatocellular carcinoma recurrence after curative-intent resection or local ablation therapy and to retard disease progression after locoregional therapy. In the future, further implementation of immune-checkpoint inhibitors and other forms of immunotherapy are expected to bring a new paradigm to the management of hepatocellular carcinoma. New insight related to immune-related adverse events with the use of immunotherapy has allso enabled optimization of the therapeutic approach to patients with hepatocellular carcinoma. The purpose of this clinical practice guideline is to provide an up-to-date recommendation based on clinical evidence and experience from expert Asia-Pacific key opinion leaders in the field of hepatocellular carcinoma. Three key questions will be addressed, namely: (1) Which patients with hepatocellular carcinoma should be considered for systemic therapy? (2) Which systemic therapy should be used? (3) How should a patient planned for immune checkpoint-based systemic therapy be managed and monitored?

在亚太地区,肝细胞癌是一个严重的健康威胁,每年导致60多万人死亡,占全球病例的70%以上。临床上,未满足的主要需求是治疗目的手术、肝移植或局部消融后的复发,以及不适合切除或局部治疗失败的肝细胞癌患者的疾病进展。近年来,新的靶向治疗和免疫检查点抑制剂已被注册为全身治疗来解决这些问题。值得注意的是,新形式的全身治疗,无论是作为一线或二线治疗不可切除的肝细胞或那些不适合局部治疗,现在是可用的。新的数据也显示,使用全身治疗来预防肝细胞癌在治疗意图切除或局部消融治疗后复发,并在局部治疗后延缓疾病进展。在未来,进一步实施免疫检查点抑制剂和其他形式的免疫治疗有望为肝细胞癌的治疗带来新的范式。与使用免疫疗法相关的免疫相关不良事件的新见解也使肝细胞癌患者的治疗方法得以优化。本临床实践指南的目的是根据亚太地区肝细胞癌领域专家的临床证据和经验提供最新的建议。将解决三个关键问题,即:(1)哪些肝细胞癌患者应该考虑进行全身治疗?(2)应该采用哪种全身治疗?(3)计划接受免疫检查点全身治疗的患者应如何管理和监测?

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临床指南
APASL:肝细胞癌的全身治疗临床实践指南(2024)
发布时间:  2024年11月20日
制定者:  
亚太肝脏研究学会(APASL,Asian-Pacific Association for the Study of the Liver)

216人浏览

0收藏

0次下载

摘要

In Asia-Pacific region, hepatocellular carcinoma is a serious health threat attributing to over 600,000 deaths each year and account for over 70% of global cases. Clinically, the major unmet needs are recurrence after curative-intent surgery, liver transplantation or local ablation and disease progression in those with hepatocellular carcinoma not eligible for resection or failed locoregional therapy. In the recent few years, new targeted therapy and immune-checkpoint inhibitors have been registered as systemic therapy to address these issues. Notably, new forms of systemic therapy, either as first-line or second-line therapy for unresectable hepatocellular or those not eligible for locoregional therapy, are now available. New data is also emerging with the use of systemic therapy to prevent hepatocellular carcinoma recurrence after curative-intent resection or local ablation therapy and to retard disease progression after locoregional therapy. In the future, further implementation of immune-checkpoint inhibitors and other forms of immunotherapy are expected to bring a new paradigm to the management of hepatocellular carcinoma. New insight related to immune-related adverse events with the use of immunotherapy has allso enabled optimization of the therapeutic approach to patients with hepatocellular carcinoma. The purpose of this clinical practice guideline is to provide an up-to-date recommendation based on clinical evidence and experience from expert Asia-Pacific key opinion leaders in the field of hepatocellular carcinoma. Three key questions will be addressed, namely: (1) Which patients with hepatocellular carcinoma should be considered for systemic therapy? (2) Which systemic therapy should be used? (3) How should a patient planned for immune checkpoint-based systemic therapy be managed and monitored?

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