瑞戈非尼联合卡瑞利珠单抗治疗难治性肝复发癌获得完全缓解病例的临床经验  

Clinical experience of regorafenib combined with camrelizumab in the treatment of refractory recurrent liver cancer with complete remission

作　　者：蒋经柱 李浩权 王在国 叶振伟 陈韵壕 张伟标 廖景升 JIANG Jingzhu;LI Haoquan;WANG Zaiguo;YE Zhenwei;CHEN Yunhao;ZHANG Weibiao;LIAO Jingsheng(Department of Hepatobiliary and Panereatic Surgery,Dongguan Hospital Affliated to Southern Medical University,Dongguan,Guangdong 523059,P.R.China;Nuclear Medicine Department,Dongguan Hospital Afliated to Southerm Medical University,Donguan,Guangdong 523059,P.R.China;Internal Medicine of Digestive Oncology,Dongguan Hospital Afiliated to Southern Medical University,Dongguan,Guangdong 523059,P.R.China)

机构地区：[1]南方医科大学附属东莞医院肝胆胰外科,广东东莞523059 [2]南方医科大学附属东莞医院核医学科,广东东莞523059 [3]南方医科大学附属东莞医院消化肿瘤内科,广东东莞523059

出　　处：《中国普外基础与临床杂志》2022年第9期1149-1153,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的 探讨难治性肝复发癌的治疗新方法。方法 对南方医科大学附属东莞医院肝胆胰外科使用二线靶向药物瑞戈非尼联合卡瑞利珠单抗治疗的1例难治性肝复发癌获得完全缓解(complete remission,CR)患者的治疗过程及治疗效果进行回顾性分析与总结。结果 该患者在前期近3年时间内先后经过根治性消融、肝中叶复发癌切除、肝S2及S8段复发癌消融及一线靶向药物仑伐替尼多学科多种方法治疗,仍然出现肝内广泛复发转移,最后改用二线靶向药物瑞戈非尼联合卡瑞利珠单抗进行全身系统治疗,肝内病变全部液化坏死且大部分明显缩小或消失,甲胎蛋白由最高峰值20 867.00μg/L降至正常,治疗效果评价为CR且稳定维持已超过12个月,无明显毒副反应,生活质量好,坚持正常工作。结论 二线靶向药物瑞戈非尼联合免疫新疗法,仍然有可能对经过各种综合治疗失败的难治性肝复发癌产生疗效,甚至获得长期无瘤生存的希望和机会。Objective To explore a new method for the treatment of refractory recurrent liver cancer.Methods The treatment process and effect of a patient with refractory recurrent liver cancer who received complete remission(CR) treated with second-line targeted drug regorafenib combined with camrelizumab in the Department of Hepatobiliary and Pancreatic Surgery of Dongguan Hospital Affiliated to Southern Medical University were retrospectively analyzed and summarized. Results In the previous 3 years, the patient underwent radical ablation,resection of recurrent cancer in the middle lobe of the liver, ablation of recurrent cancer in S2 and S8 segments of the liver,and multidisciplinary treatment with the first-line targeted drug lenvatinib, extensive intrahepatic recurrence and metastasis still occurred. Finally, the patient was treated with the second-line targeted drug regorafenib combined with camrelizumab for systemic treatment. All the intrahepatic lesions were liquefied and necrotic, and most of them were significantly reduced or disappeared, AFP decreased from the highest peak of 20 867.00 μg/L to normal. The therapeutic effect of CR was evaluated and remained stable for more than 12 months. There were no obvious toxic and side effects.The patient had a good quality of life and insisted on working normally. Conclusion The second-line targeted drug regorafenib combined with new immunotherapy may still have curative effect on refractory recurrent liver cancer after various comprehensive treatment failures, and even obtain the hope and opportunity of long-term tumor-free survival.

关 键 词：肝细胞癌 复发癌 治疗 瑞戈非尼 卡瑞利珠单抗 

分 类 号：R735.7[医药卫生—肿瘤]