Local and systemic therapy in liver cancer: the quest for synergy
Mené en Chine entre 2019 et 2021 sur 33 patients atteints d'un carcinome hépatocellulaire de stade localement avancé et non résécable (durée médiane de suivi : 17,2 mois ; 97 % d'hommes), cet essai multicentrique de phase II évalue la faisabilité d'un traitement combinant une chimioembolisation transartérielle séquentielle et une radiothérapie corporelle stéréotaxique suivie d'avélumab
Immune checkpoint inhibitor-based therapies have ushered in a new era in the systemic treatment of advanced hepatocellular carcinoma. The durable responses and unprecedented survival rates observed in immune checkpoint inhibitor combination studies provide a compelling justification for the integration of immunotherapy for patients with intermediate-stage hepatocellular carcinoma, a highly heterogeneous patient group in which survival has plateaued at approximately 20 months. Several phase 3 trials are currently testing immune checkpoint inhibitors in combination with locoregional therapies. Local tumour destruction mediated by locoregional therapies translates into innate and adaptive immune activation, which can be further enhanced by immune checkpoint inhibitors, leading to synergistic immunogenic cell death.
The Lancet Gastroenterology & Hepatology , commentaire, 2021