Dados do Resumo

Título

Monoclonal Antibodies against Hepatocellular Carcinoma: a Systematic Review and Comparison of Recent Studies

Introdução

Hepatocellular carcinoma (HCC) is one of the most aggressive types of cancer and the main cause of death by liver cancer. Although treatments such as Sorafenib have brought advancements there is critical need for new approaches. Immunotherapy, particularly with monoclonal antibodies, has shown significant potential. This review discusses recent discoveries regarding the use of monoclonal antibodies for advanced HCC treatment, highlighting its efficiency and safety profile.

Objetivo

The objective of this study is to explore innovations in cell therapy, through a literature review, interpreting possible challenges and unfoldings during clinical applications along with future perspectives on the use of monoclonal antibodies to treat hepatocellular carcinoma.

Métodos

The study is an integrative literature review based on a bibliographic overview of the “PubMed” database. The established descriptors were “hepatocellular carcinoma” and “monoclonal antibodies”, connected by the Boolean operator “AND”, filtered by the last five years (2019-2024), with full text available focusing on clinical trials and meta-analysis. In total 61 articles were found, after careful analysis only 11 publications were chosen, a rigorous inspection of the main results was conducted.
During the publications selection process the exclusion criteria was: articles that address topics that differ from the chosen one, articles that do not reach a conclusion in relation to the topic and articles that emphasize one specific medication. There were no restrictions regarding the age range or language of the publications.

Resultados

The treatment of Hepatocellular Carcinoma (HCC) presents numerous immunological alterations. Nivolumab showed efficacy in advanced HCC, with a 15-20% response rate and 15,6 months of overall survival (OS), superior to Sorafenib. Even though intraperitoneal Sintilimab had a 30,77% response rate and a 43,75% reduction in ascites in HCC and cholangiocarcinoma, Ramucirumab showed better results in patients with Child-Pugh A cirrhosis, achieving 4 months progression free survival (PFS) and 12 months OS.
The combination of Tislelizumab and Lenvatinib showed a 38.7% response rate and a PFS of 8.2 months, but 28.1% of cases presented severe adverse events. Lenvatinib outperforms PD-1/PD-L1 inhibitors in OS and PFS, according to meta-analyses. Cost-effectiveness analysis examined the effects of Sintilimab and Camrelizumab compared to other agents; both improved OS and PFS compared to Sorafenib, while Tislelizumab stands out for reducing costs and increasing quality adjusted life-years (QALY).

Conclusões

The present studies on the use of monoclonal antibodies to treat advanced HCC show promising advances. Nivolumab, Sintilimab, Ramucirumab and combinations such as Tislelizumab e Lenvatinib show better response and survival rates when compared to Sorafenib. However, severe adverse effects along with variations in effectiveness emphasize the need for personalized therapies. Immunotherapy with monoclonal antibodies is an innovative strategy that requires study to achieve clinical optimization.

Palavras Chave

cell therapy; monoclonal antibodies; hepatocellular carcinoma