肝细胞癌的免疫治疗进展

李敏; 刘信; 袁丹丹; 王建国; 陈江

doi:10.7659/j.issn.1005-6947.250478

中国普通外科杂志 ›› 2025, Vol. 34 ›› Issue (08) : 1618 -1632. DOI: 10.7659/j.issn.1005-6947.250478

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肝细胞癌的免疫治疗进展

李敏 ¹^,² ,
刘信 ²^,³ ,
袁丹丹 ²^,⁴ ,
王建国 ²^,⁵ ,
陈江 ²^,⁶ ,

作者信息 +

Advances in immunotherapy for hepatocellular carcinoma

Min LI ¹^,² ,
Xin LIU ²^,³ ,
Dandan YUAN ²^,⁴ ,
Jianguo WANG ²^,⁵ ,
Jiang CHEN ²^,⁶ ,
Dan Gabriel DUDA ²^,⁷

Author information +

^1.Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

^2.Edwin. L. Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA

^3.Center of Hepato-Pancreato-Biliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China

^4.Department of Gastroenterology Oncology, Shandong Cancer Hospital and Institute/Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan 250117, China

^5.Department of Hepatobiliary Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital/Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China

^6.Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310009, China

^7.Transplant Oncology and Therapeutics Program, Department of Surgery, Houston Methodist Academic Institute, Houston, TX 77030 USA

Dan Gabriel Duda, Email: duda@steele.mgh.harvard.edu, ORCID: 0000-0001-7065-8797.

Dan Gabriel Duda, DMD, PhD, is a professor of Radiation Oncology at Harvard Medical School and Director of Translational Research in Gastrointestinal Radiation Oncology at Massachusetts General Hospital, Boston, USA. His research focuses on tumor-microenvironment interactions. Email: duda@steele.mgh.harvard.edu, ORCID: 0000-0001-7065-8797.

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摘要

原发性肝癌（PLC）是全球发病率和病死率均较高的常见恶性肿瘤。肝细胞癌（HCC）是PLC的主要类型，在亚洲多由乙型肝炎病毒感染引起。尽管近年来在靶向治疗和局部治疗方面取得了进展，但其5年生存率依然较低，提示现有治疗手段疗效有限。免疫治疗的出现，特别是免疫检查点抑制剂（ICI），为PLC患者带来了新的希望。然而，由于肝脏独特的免疫微环境，免疫治疗在HCC中的疗效仍面临严峻挑战。本文综述了近年来肝癌免疫治疗的研究进展，重点讨论ICI、联合治疗、新兴疗法以及未来的发展方向。

Abstract

Primary liver cancer (PLC) is a prevalent malignancy with high incidence and mortality rates globally. Hepatocellular carcinoma (HCC), primarily resulting from hepatitis B virus infections in Asia, constitutes most PLC cases. Despite advancements in targeted therapies and localized treatments, the 5-year survival rate remains low, indicating limited efficacy of current approaches. The advent of immunotherapy, particularly immune checkpoint inhibitors (ICIs), has brought new hope for patients with PLC. However, the liver's unique immune microenvironment presents significant challenges to the effectiveness of immunotherapy in HCC. This article reviews recent research developments in liver cancer immunotherapy, focusing on ICIs, combination therapies, emerging treatments, and prospective future directions.