Programmed cell death protein 1 and tyrosine kinase inhibition plus transcatheter arterial chemoembolization of advanced hepatocellular carcinoma

作者：Wei Peng, Xiaoyun Zhang, Chuan Li, Xinrui Zhu, Qiu Li, Weixia Chen, Wusheng Lu, Chang Liu, Yongjie Zhou, Yujun Shi, Tianfu Wen, Xin Sun · 发表于：British journal of surgery · 年份：2022 · DOI：10.1093/bjs/znac334 · 被引用次数：12 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Hepatitis C virus research、Liver Disease Diagnosis and Treatment

Most patients with hepatocellular carcinoma (HCC) are diagnosed with intermediate- or advanced-stage disease1 but resection with clear margins offers the best opportunity for cure2. Conversion therapy (to make the tumour resectable) has not been used routinely because of lack of evidence3. The present study described the process of conceptualization, preparation, and implementation of a novel conversion therapy strategy using the IDEAL (Idea, Development, Exploration, Assessment, Long-term study) framework4. This prospective, single-arm, single-centre, IDEAL phase 1 study (10 August 2020 and 10 January 2021) was approved by the ethics committee of West China Hospital (2020-836). It was the initial component of a prospective clinical trial that was registered with ClinicalTrials.gov (NCT04997850). Salvage liver resection after a lenvatinib plus transarterial chemoembolization (TACE) and programmed cell death protein 1 (PD-1) inhibitor (LEN-TAP) strategy for unresectable HCC (uHCC) was initiated after several meetings of the multidisciplinary team for HCC of West China Hospital. Details of the conceptualization of LEN-TAP, patient selection and study design, institutional review board approvals and patient consent, prospective database, LEN-TAP regimen, safeguards, efficacy assessment, and salvage liver resection after LEN-TAP are available in the supplementary material. Six of seven patients had advanced HCC with macrovascular invasion. Baseline characteristics are summarized ...