肝细胞癌靶向治疗的进展 - 天津北方网——权威媒体 .pptVIP

Survival and miR-26a Expression in HCC March 2007 ? Slide * Science For A Better Life HealthCare Biological and Molecular Targeted Therapy for HHC Sheng-Long Ye, MD, PhD Liver Cancer Institute Zhongshan Hospital Fudan University Shanghai, China Problem in HCC Severe cirrhosis Intrahepatic spread and distant metastasis Low resectability High postoperative recurrence Non-Surgical Treatment Regional therapy – TACE Ablation therapy – PEI, RFA, MWCT, Laser, HIFU, Cryoablation Radiotherapy Chemotherapy Biological Molecular targeted therapy Traditional Chinese medicine Biotherapy for HCC Cytokines－－IFNα、Tα1、IL-2 Adoptive immunotherapy－－CIK、CTL Radioimmunotherapy－－I131 Metuximab Tumor vaccines－－DC vaccine Gene therapy－－Clinical investigation Median survival time： IFN 63.8m vs Control 38.8m IFNαprevents recurrence and prolongs survival in postresective HCC patients Randomized control clinical trial of 236 HCC cases with 6-year follow-up N Engl J Med 2009; 361: 1437-1447 Prevention of Postresective Recurrence in HCC by LAK/IL-2 3.8 15 .4 26 .9 28 .8 34 .6 Recurrence% 17.7 31 .1 32 .5 37.8 61 .5 Combination Treatment of p53 TACE in HCC * ** ** *P0.05 **P0.01 Strategy for Molecular Targeted therapy Growth factor receptor inhibitors Angiogenesis inhibitors Signal transduction pathway inhibitors Monoclonal antibodies Cell-cycle modulation gene therapy Targets Drugs EGFR: TKI: Erlotinib, Lapatinib Gefitinib Ab: Cetuximab VEGF TKI: Sorafenib Sunitinib Ab: Bevacizumab RAF TKI: Sorafenib mTOR Rapamycin Everolimus Protease Inhibitor Bortezomib Targeted Therapy for HCC Endpoint Oriental1 SHARP2 Hazard Ratio (95% CI) P-value Hazard Ratio (95% CI) P-value OS 0.68 (+47%) 0.014 0.69 (+44%) 0.001 (0.50-0.93) (0.55-0.87) TTSP 0.90 0.498 1.08 0.768 (0.67-1.22) (0.88-1.31) TTP 0.57 (+74%) 0.001 0.58 (+73%) 0.001 (0.42-0.79) (0.45-0.74) PFS 0.62 0.001 0.65 0.001 (0.46-0.82) (0.52-0.79) 2. Llovet JM et al. NEJM 2008, 359: 378-390. 1. Cheng A et al. La