摘要
近年来随着大量肝细胞癌(hepatocellular carcinoma,HCC)临床研究数据的公布,美国肝病研究学会(American Association for the Study of Liver Diseases,AASLD)、美国国家综合癌症网络(National Comprehensive Cancer Network,NCCN)、美国临床肿瘤学会(American Society of Clinical Oncology,ASCO)和我国国家卫生健康委员会均针对HCC做出诊疗指南更新。AASLD 2023、NCCN 2024与中国《原发性肝癌诊疗指南(2024年版)》(CNLC 2024)对于HCC风险人群的定义不存在差异,其中CNLC 2024根据我国罹患肝癌人群的特征,针对HCC高危因素与早期筛查手段做出更新。4部指南对于HCC新辅助和辅助治疗、局部治疗、系统治疗等方面的更新较多。CNLC 2024细化了局部治疗适应证,完善了系统治疗策略,新增甲磺酸阿帕替尼联合卡瑞利珠单抗、替雷利珠单抗作为一线用药。AASLD 2023、NCCN 2024和ASCO 2024推荐的晚期二线方案纳武利尤单抗+伊匹木单抗或成为晚期HCC的新一线药物治疗选择。笔者对该4部指南进行了比较解读。
With the publication of a vast amount of clinical research on hepatocellular carcinoma(HCC),the American Association for the Study of Liver Diseases(AASLD),the National Comprehensive Cancer Network(NCCN),the American Society of Clinical Oncology(ASCO),and the National Health Commission of China have all updated their diagnostic and treatment guidelines for HCC.There are no differences in the definition of HCC risk populations among the AASLD 2023,NCCN 2024,and China Liver Cancer Staging and Treatment Guideline(CNLC)2024.Notably,CNLC 2024 has updated its guidance on high-risk factors and prospective surveillance for HCC based on the characteristics of HCC patients in China.The four guidelines have seen significant updates in the areas of neoadjuvant and adjuvant therapies,local treatments,and systemic treatments for HCC.CNLC 2024 refines the indications for local treatment,improves systemic treatment,and introduces new first-line therapy,including camrelizumab combined with rivoceranib or tislelizumab.The second-line therapy nivolumab plus ipilimumab for advanced HCC are recommended by AASLD 2023,NCCN 2024,and ASCO 2024,which may become a new first-line therapeutic option for patients with advanced HCC.We compare and interpret these four guidelines in this paper.
作者
徐若翔
曾智明
朱广志
韩创业
严律南
彭涛
XU Ruoxiang;ZENG Zhiming;ZHU Guangzhi;HAN Chuangye;YAN Lünan;PENG Tao(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,P.R.China;Department of Medical Oncology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,P.R.China;Division of Liver Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer,Nanning 530021,P.R.China)
出处
《中国普外基础与临床杂志》
2025年第2期184-191,共8页
Chinese Journal of Bases and Clinics In General Surgery
关键词
肝细胞癌
美国肝病研究学会指南
美国国家综合癌症网络指南
美国临床肿瘤学会指南
中国《原发性肝癌诊疗指南(2024年版)》
解读
hepatocellular carcinoma
American Association for the Study of Liver Diseases Guideline
National Comprehensive Cancer Network Guideline
American Society of Clinical Oncology Guideline
China Liver Cancer Staging and Treatment Guideline(version-2024)
interpretation
