肝细胞癌的双免治疗现状与进展OA

The treatment of hepatocellular carcinoma has entered the era of combination immunotherapy.Dual immune checkpoint block-ade regimens such as O+Y and STRIDE regimens have become standard first-line options based on pivotal phase Ⅲ trials.Their core value lies in inducing deep and durable immune responses,generating a significant"tail effect"that offers the potential for long-term survival in some patients and provides an immunotherapy-only option for those with contraindications to antiangiogenic therapy.However,their effica-cy remains heterogeneous and challenges persist,including the early crossing of survival curves and discordance with traditional Response Evaluation Criteria in Solid Tumors(RECIST).Clinical decision making requires personalized trade-offs:for patients requiring rapid tumor shrinkage(e.g.,those with portal vein tumor thrombus),targeted therapy plus immunotherapy offers advantages in early disease control;for those prioritizing long-term survival,with poor liver function,or with specific contraindications,the value of dual immunotherapy becomes prominent.Future directions include exploring"dual immunotherapy-based"combination strategies and agents targeting novel checkpoints such as lymphocyte activation gene-3(LAG-3)and T cell immunoglobulin and mucin domain-containing protein 3(TIM-3),as well as utilizing biomarkers to enable precise diagnosis and treatment,and propel therapy toward a new era of"patient matching".