Аннотация
Появление мультикиназных ингибиторов (МКИ) и ингибиторов иммунных контрольных точек (ИИКТ) изменило перспективы лечения гепатоцеллюлярного рака (ГЦР). Комбинированная терапия, включающая в себя ИИКТ, пришла на смену сорафенибу как препарату 1-й линии для лечения распространенного ГЦР по причине лучших показателей эффективности и выживаемости по результатам недавно опубликованных клинических исследований III фазы. Однако роль ленватиниба при применении в качестве терапии 1-й линии все еще не ясна, поскольку ни в одном из проспективных исследований не было выполнено сравнение его эффективности с эффективностью ИИКТ при распространенном ГЦР. Несколько ретроспективных исследований показали, что ленватиниб, применяемый в качестве терапии 1-й линии, может не уступать комбинации c ИИКТ. Более того, появляется все больше доказательств того, что лечение ИИКТ связано с худшими исходами у пациентов с ГЦР невирусной этиологии. Это ставит под вопрос превосходство лечения ИИКТ у всех пациентов и выдвигает применение ленватиниба в качестве терапии 1-й линии на первый план как потенциально предпочтительный вариант лечения. Кроме того, накопленные данные подтверждают, что при распространенном ГЦР промежуточной стадии с высокой опухолевой нагрузкой применение ленватиниба в 1-й линии или в комбинации с трансартериальной химиоэмболизацией (ТАХЭ) является предпочтительным вариантом лечения по сравнению с самостоятельным применением ТАХЭ. В настоящем обзоре представлены новейшие данные, подтверждающие растущую роль ленватиниба в 1-й линии терапии при ГЦР. (Clin Mol Hepatol. 2023; 29: 909–923)
Ключевые слова: гепатоцеллюлярный рак; антинеопластические препараты; ингибитор иммунной контрольной точки.
Об авторе
Л.Л. Чан1, С.Л. Чан1,2
1Отделение клинической онкологии, Больница принца Уэльского, Китайский университет Гонконга, Специальный административный район Гонконг, Китайская Народная Республика;
3Государственная лаборатория трансляционной онкологии, Онкологический центр сэра Юэ Конг Пао, Гонконгский институт рака, Специальный административный район Гонконг, Китайская Народная Республика
chanlam_stephen@cuhk.edu.hk
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Для цитирования:Чан Л.Л., Чан С.Л. Эволюционная роль ленватиниба в 1-й линии лечения гепатоцеллюлярного рака в новую эру лекарственной терапии. Клинический разбор в общей медицине. 2024; 5 (7): 24–36. DOI: 10.47407/kr2024.5.7.00445
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