Лечение метастатического гепатоцеллюлярного рака ленватинибом. Клинический случай и обзор литературы
Лечение метастатического гепатоцеллюлярного рака ленватинибом. Клинический случай и обзор литературы
Меньшиков К.В., Султанбаев А.В., Ахметгареева К.Т., Липатов Д.О. Лечение метастатического гепатоцеллюлярного рака ленватинибом. Клинический случай и обзор литературы. Современная Онкология. 2021; 23 (1): 156–160. DOI: 10.26442/18151434.2021.1.200785
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Menshikov KV, Sultanbaev AV, Akhmetgareeva KT, Lipatov DO. Treatment of metastatic hepatocellular carcinoma with lenvatinib. Case report and literature review. Journal of Modern Oncology. 2021; 23 (1): 156–160.
DOI: 10.26442/18151434.2021.1.200785
Лечение метастатического гепатоцеллюлярного рака ленватинибом. Клинический случай и обзор литературы
Меньшиков К.В., Султанбаев А.В., Ахметгареева К.Т., Липатов Д.О. Лечение метастатического гепатоцеллюлярного рака ленватинибом. Клинический случай и обзор литературы. Современная Онкология. 2021; 23 (1): 156–160. DOI: 10.26442/18151434.2021.1.200785
________________________________________________
Menshikov KV, Sultanbaev AV, Akhmetgareeva KT, Lipatov DO. Treatment of metastatic hepatocellular carcinoma with lenvatinib. Case report and literature review. Journal of Modern Oncology. 2021; 23 (1): 156–160.
DOI: 10.26442/18151434.2021.1.200785
Гепатоцеллюлярный рак (ГЦР), или печеночно-клеточный рак, – самая частая первичная злокачественная опухоль печени, характеризующаяся прежде всего неблагоприятным прогнозом. В Республике Башкортостан за 2019 г. и период январь–апрель 2020 г. диагноз ГЦР был установлен у 92 (62,6%) пациентов, среди них 68,47% – IV стадия опухолевого процесса. Международные профессиональные рекомендации предлагают проведение скрининга для выявления ГЦР на ранних стадиях. Согласно профессиональным рекомендациям лекарственная системная терапия является методом выбора при неоперабельном ГЦР. Одним из актуальных методов распространенной терапии ГЦР является ингибирование пути VEGF. Ленватиниб – препарат из группы ингибиторов тирозинкиназ для лечения распространенного, не подлежащего локальному лечению ГЦР. В статье описан клинический случай успешной терапии пациента 67 лет с распространенным ГЦР, у которого назначение таргетной терапии ленватинибом при ГЦР, не подлежащем локальным методам лечения, привело к длительной стабилизации. С первых недель терапии наблюдалась положительная динамика в состоянии пациента. Восстановлена трудоспособность. Терапия показала удовлетворительный профиль переносимости.
Hepatocellular carcinoma (HCC) or liver cancer is the most common primary malignant tumor of the liver, which is characterized on the first place by a poor prognosis. HCC was diagnosed in 92 patients (62.6%) in 2019 and the period from January to April 2020 in the Republic of Bashkortostan, and among them, 68.47% had stage IV cancer. International professional guidelines suggest screening for early HCC detection. Systemic drug therapy is the treatment of choice for inoperable HCC according to professional guidelines. Inhibition of the VEGF pathway is one of the current methods of therapy for advanced HCC. Lenvatinib is a tyrosine kinase inhibitor for the treatment of advanced HCC that is not subject to local interventions. This article provides a description of a clinical case of successful treatment of a 67-year-old patient with advanced hepatocellular carcinoma. He was appointed for targeted therapy with lenvatinib for HCC that was not subject to local interventions, which led to long-term stabilization. There was a positive trend in the patient's condition from the first weeks of therapy. The working capacity was restored. The therapy showed a satisfactory tolerability profile.
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________________________________________________
1. Torre LA, Siegel RL, Elizabeth M. Ward and Ahmedin Jemal. Global Cancer Incidence and Mortality Rates and Trends – An Update. Cancer Epidemiol Biomarkers Prev 2016; 25: 16–27.
2. Jemal A, Ward EM, Johnson CJ, et al. Annual Report to the Nation on the Status of Cancer, 1975–2014, Featuring Survival. J Natl Cancer Inst 2017; 109 (9).
3. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394–424.
4. The state of cancer care for the population of Russia in 2019. Ed. AD Kaprina, VV Starinsky, AO Shahazadova. MNIOI them. PA Herzen is a branch of the Federal State Budgetary Institution "National Medical Research Center of Radiology" of the Ministry of Health of Russia. Moscow, 2020 (in Russian)
5. Akhmetgareeva KT, Lipatov ON, Menshikov KV, Sultanbaev AV. The incidence of primary liver cancer in the Republic of Bashkortostan. In the book: White Nights 2020. Abstracts of the VI St. Petersburg International Oncological Forum. Saint Petersburg, 2020; p. 22 (in Russian)
6. Tseng C-H, Hsu Y-C, Chen T-H, et al. Hepatocellular carcinoma incidence with tenofovir versus entecavir in chronic hepatitis B: A systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 5: 1039–52.
7. Carrat F, Fontaine H, Dorival C, et al. Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: A prospective cohort study. Lancet 2019; 393: 1453–64.
8. Kubota N, Fujiwara N, Hoshida Y. Clinical and Molecular Prediction of Hepatocellular Carcinoma Risk. J Clin Med 2020; 9: 3843.
9. Pazgan-Simon M, Simon KA, Jarowicz E, et al. Hepatitis B virus treatment in hepatocellular carcinoma patients prolongs survival and reduces the risk of cancer recurrence. Clin Exp Hepatol 2018; 4 (3): 210–6. DOI: 10.5114/ceh.2018.78127
10. Breder VV, Laktionov KK, Davydov MM. Lekarstvennoe lechenie gepatotselliuliarnogo raka: prakticheskie voprosy i resheniia. Meditsinskii sovet. 2017; 14: 11–23 (in Russian)
DOI: 10.21518/2079-701X-2017-14-11-23
11. Kieran MW, Kalluri R, Cho YJ. The VEGF pathway in cancer and disease: responses, resistance, and the path forward. Cold Spring Harb Perspect Med. 2012; 2.
12. Carlomagno F, Anaganti S, Guida T, et al. BAY 43-9006 inhibition of oncogenic RET mutants. J Natl Cancer Inst 2006; 98 (5): 326–34.
13. Llovet JJM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359 (4): 378–390.
14. Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet 2018; 391: 1163–73.
15. Vogel A, Qin S, Kudo M, et al. Health-Related Quality of Life (HRQOL) and Disease Symptoms in Patients with Unresectable Hepatocellular Carcinoma (HCC) Treated with Lenvatinib (LEN) or Sorafenib (SOR). Ann Oncol 2017; 28 (Suppl. 5): v209–v268. DOI: 10.1093/annonc/mdx369.002