医学
免疫疗法
实体瘤疗效评价标准
肝细胞癌
肿瘤科
叙述性评论
内科学
重症监护医学
疾病
癌症
进行性疾病
作者
Roberto Cannella,Sara Lewis,Leonardo Gomes da Fonseca,Maxime Ronot,Jordi Rimola
出处
期刊:American Journal of Roentgenology
[American Roentgen Ray Society]
日期:2022-10-01
卷期号:219 (4): 533-546
被引量:3
摘要
The advent of immunotherapy for patients with hepatocellular carcinoma (HCC) has changed the treatment landscape and conferred a survival benefit on patients with advanced HCC, who typically have a very poor prognosis. The most pronounced improvements in response, as documented by standardized response criteria based on CT or MRI, have been achieved when immunotherapy is combined with other systemic or locoregional therapies. Immune checkpoint inhibitor treatments result in unique patterns on CT and MRI that challenge the application of conventional response criteria such as RECIST, modified RECIST, and European Association for the Study of the Liver criteria. Thus, newer criteria have been developed to gauge therapy response or disease progression for patients receiving immunotherapy, including immune-related RECIST (iRECIST) and immune-modified RECIST (imRECIST), though these remain unvalidated. In this review, we describe the current landscape of immunotherapeutic agents used for HCC, summarize the results of published studies, review the pathobiologic mechanisms that provide a rationale for the use of these agents, and report on the status of response assessment for immunotherapy either alone or in combination with other treatment options. Finally, consensus statements are provided to inform radiologists about essential considerations in the era of a rapidly changing treatment paradigm for patients with HCC.
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