[Sequential surgery following conversion therapy based on the combination of immune checkpoint inhibitors and antiangiogenic targeted drugs alters the treatment landscape and outcomes for advanced hepatocellular carcinoma].

Résumé

Hepatocellular carcinoma (HCC) often presents insidiously, and the majority of patients are diagnosed at an advanced stage, missing the opportunity for curative surgery. In recent years, breakthrough advances in systemic therapy, particularly represented by the combination of immune checkpoint inhibitors (ICI) and antiangiogenic targeted drugs (AATD), have driven a paradigm shift in the treatment modality for advanced HCC. This article elaborates on the definition and theoretical basis of conversion therapy, analyses the strategy for selecting conversion treatment regimens centered on immune-targeted combination therapy, defines the timing and value of sequential surgical therapy following conversion, and demonstrates the significant survival benefits brought by this strategy through multiple clinical study evidences. Evidence indicates that conversion therapy based on immune-targeted combinations followed by sequential surgery has emerged as a novel treatment mode for advanced HCC. Guided by multidisciplinary collaboration and personalized decision-making, it can tangibly improve long-term survival outcomes for patients.