Perioperative camrelizumab plus rivoceranib versus surgery in resectable hepatocellular carcinoma
Mené sur 294 patients atteints d'un carcinome hépatocellulaire résécable à haut risque ou risque intermédiaire de récidive (durée médiane de suivi : 21,3 mois), cet essai randomisé de phase II/III évalue l'efficacité, du point de vue de la survie sans événement, et la toxicité d'un traitement périopératoire combinant camrélizumab et rivocéranib
Historically, hepatocellular carcinoma was deemed to be inherently drug resistant due to the presence of multidrug resistance genes that increased drug efflux and reduced drug uptake. For decades, multiple trials investigating systemic therapy for advanced hepatocellular carcinoma had failed to show clinical efficacy. In 2008, Llovet and colleagues1 reported that median survival and the time to radiological progression were nearly 3 months longer for patients treated with sorafenib versus placebo. Subsequently, the phase 3 IMbrave150 study established atezolizumab plus bevacizumab as superior to sorafenib in patients with unresectable hepatocellular carcinoma.2 In 2023, the randomised phase 3 CARES-310 trial showed that the camrelizumab plus rivoceranib regimen improved progression-free and overall survival, compared with sorafenib, for unresectable hepatocellular carcinoma.3 Over the past several decades, the use of perioperative (ie, preoperative and postoperative) chemotherapy has been increasingly adopted for a range of gastrointestinal cancers, including gastric, pancreatic, and rectal. The use of preoperative chemotherapy has some initial appeal—quicker treatment of systemic disease, in-situ presence of cancer antigens to facilitate immune response, and ability to assess treatment response are some of its advantages.
The Lancet , commentaire, 2025