Progress of complete response status after conversion therapy for hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Shuaihang ^1,2 ,  WANG Haiqing ²

1. School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;
2. Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu 610041, P. R. China;

Corresponding?author：

WANG Haiqing, Email: wanghaiqing241286@163.com

Keywords：

hepatocellular carcinoma; complete response; pathological complete response; therapy

DOI：

10.7507/1007-9424.202304036

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the complete response (CR, which referred to the imaging level) achieved by conversion therapy for hepatocellular carcinoma (HCC) in the current researches, and explore the further therapy strategies and outcomes for patients acquired CR. Method The domestic and foreign literature on the research of CR achieved by conversion therapy for HCC was reviewed and summarized. Results With the great progress of conversion therapy such as local therapy, systemic therapy, and local therapy in combination with systemic therapy for HCC, the proportion of the CR was increasing after conversion therapy. For the patients who achieved CR after conversion therapy, the surgical resection, liver transplantation, follow-up observation, etc. could be selected and showed a survival benefit. Conclusions From the opinion summarized in this review, with the development of targeted therapy and immunotherapy, as well as the new anti-tumor drugs, a growing number of conversion therapeutic schedules could be provided, CR rate was increasing. At present, for patients who have achieved CR after conversion therapy, surgical or non-surgical treatment can be chosen. However, there is no authoritative conclusion on which therapy method can benefit patients more. The current strategy is to perform personalized treatment plan based on the individual situation of patient, in order to achieve better survival benefit for patient.

Citation： LU Shuaihang, WANG Haiqing. Progress of complete response status after conversion therapy for hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(9): 1138-1145. doi: 10.7507/1007-9424.202304036 Copy

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3. Park JW, Chen M, Colombo M, et al. Global patterns of hepatocellular carcinoma management from diagnosis to death: the BRIDGE Study. Liver Int, 2015, 35(9): 2155-2166.
4. 衛澤源, 戴朝六. 肝癌轉化治療相關評估指標及價值. 中國實用外科雜志, 2021, 41(3): 337-342.
5. Vande Lune P, Abdel Aal AK, Klimkowski S, et al. Hepatocellular carcinoma: diagnosis, treatment algorithms, and imaging appearance after transarterial chemoembolization. J Clin Transl Hepatol, 2018, 6(2): 175-188.
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8. Lee JY, Lee BC, Kim HO, et al. Liver MRI and clinical findings to predict response after drug eluting bead transarterial chemoembolization in hepatocellular carcinoma. Sci Rep, 2021, 11(1): 24076. doi: 10.1038/s41598-021-01839-6.
9. Peng CW, Teng W, Lui KW, et al. Complete response at first transarterial chemoembolization predicts favorable outcome in hepatocellular carcinoma. Am J Cancer Res, 2021, 11(10): 4956-4965.
10. Lin PT, Teng W, Jeng WJ, et al. Dynamic change of albumin-bilirubin score is good predictive parameter for prognosis in chronic hepatitis C-hepatocellular carcinoma patients receiving transarterial chemoembolization. Diagnostics (Basel), 2022, 12(3): 665. doi: 10.3390/diagnostics12030665.
11. Hsu SJ, Xu X, Chen MP, et al. Hepatic arterial infusion chemotherapy with modified FOLFOX as an alternative treatment option in advanced hepatocellular carcinoma patients with failed or unsuitability for transarterial chemoembolization. Acad Radiol, 2021, 28 Suppl 1: S157-S166. doi: 10.1016/j.acra.2021.01.024.
12. Chen KT, Tsai KF, Leung HWC, et al. Hepatic arterial infusion chemotherapy followed by lipiodol infusion for advanced hepatocellular carcinoma with portal vein tumor thrombus: a single-center experience. Medicina (Kaunas), 2021, 57(8): 779. doi: 10.3390/medicina57080779.
13. Huang Y, Zhang L, He M, et al. Hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin versus sorafenib for hepatocellular carcinoma refractory to transarterial chemoembolization: retrospective subgroup analysis of 2 prospective trials. Technol Cancer Res Treat, 2022, 21: 15330338221117389. doi: 10.1177/15330338221117389.
14. Li QJ, He MK, Chen HW, et al. Hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin versus transarterial chemoembolization for large hepatocellular carcinoma: a randomized phase Ⅲ trial. J Clin Oncol, 2022, 40(2): 150-160.
15. Que J, Wu HC, Lin CH, et al. Comparison of stereotactic body radiation therapy with and without sorafenib as treatment for hepatocellular carcinoma with portal vein tumor thrombosis. Medicine (Baltimore), 2020, 99(13): e19660. doi: 10.1097/MD.0000000000019660.
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18. Salem R, Johnson GE, Kim E, et al. Yttrium-90 radioembolization for the treatment of solitary, unresectable HCC: the LEGACY study. Hepatology, 2021, 74(5): 2342-2352.
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20. Kudo M, Ueshima K, Chan S, et al. Lenvatinib as an initial treatment in patients with intermediate-stage hepatocellular carcinoma beyond up-to-seven criteria and Child-Pugh A liver function: a proof-of-concept study. Cancers (Basel), 2019, 11(8): 1084. doi: 10.3390/cancers11081084.
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25. 李雪瑞, 張雯雯, 胡丙洋, 等. 免疫聯合靶向序貫外科手術方案治療初始不可切除肝細胞癌的臨床療效評估. 中華肝膽外科雜志, 2023, 29(1): 15-21.
26. Finn RS, Qin S, Ikeda M, et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med, 2020, 382(20): 1894-1905.
27. Hiraoka A, Kumada T, Tada T, et al. Does first-line treatment have prognostic impact for unresectable HCC?-Atezolizumab plus bevacizumab versus lenvatinib. Cancer Med, 2023, 12(1): 325-334.
28. 蔣經柱, 李浩權, 王在國, 等. 免疫聯合靶向方案治療晚期肝癌臨床研究. 中國腫瘤外科雜志, 2022, 14(2): 120-126.
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30. Lencioni R, Llovet JM, Han G, et al. Sorafenib or placebo plus TACE with doxorubicin-eluting beads for intermediate stage HCC: The SPACE trial. J Hepatol, 2016, 64(5): 1090-1098.
31. 韋滔, 唐置鴻, 韋猛, 等. TACE聯合TKI及PD-1抑制劑在不可切除肝細胞癌患者轉化治療中的療效. 中國癌癥防治雜志, 2021, 13(4): 413-419.
32. Zhang J, Zhang X, Mu H, et al. Surgical conversion for initially unresectable locally advanced hepatocellular carcinoma using a triple combination of angiogenesis inhibitors, anti-PD-1 antibodies, and hepatic arterial infusion chemotherapy: a retrospective study. Front Oncol, 2021, 11: 729764. doi: 10.3389/fonc.2021.729764.
33. Wu JY, Yin ZY, Bai YN, et al. Lenvatinib combined with anti-PD-1 antibodies plus transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: a multicenter retrospective study. J Hepatocell Carcinoma, 2021, 8: 1233-1240.
34. Chao Y, Chung YH, Han G, et al. The combination of transcatheter arterial chemoembolization and sorafenib is well tolerated and effective in Asian patients with hepatocellular carcinoma: final results of the START trial. Int J Cancer, 2015, 136(6): 1458-1467.
35. 呂國悅, 蔣超, 孫曉東. 肝癌的轉化治療策略. 中華消化外科雜志, 2022, 21(2): 217-223.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Progress of complete response status after conversion therapy for hepatocellular carcinoma

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