Liver cancer intervention combined with "cocktail therapy" can significantly prolong the survival time of advanced patients
Liver cancer has an insidious onset, and only about 20% of patients can receive surgical resection when clinically discovered. Professor Xia Jinglin's team from the Department of Liver Oncology at Zhongshan Hospital Affiliated to Fudan University proposed a "cocktail therapy" for liver cancer, and recently published a research paper titled "Immunochemotherapy synergistically targeting the SAMD4B-APOA2-PD-L1 axis to enhance anti-tumor immunity in hepatocellular carcinoma" in the journal Cell Death and Disease on the effects of cocktail therapy against liver cancer and its mechanism of action.
It is reported that drug treatments for liver cancer include hepatic artery infusion chemotherapy, targeted therapy, immunotherapy, targeted combined immunotherapy, dual immunotherapy, etc. These methods can prolong the survival time of patients with advanced liver cancer to a certain extent, but the effects are not generally ideal, and there are many side effects, high costs, and inconvenient treatment. The clinical application effect of interventional combined targeted immunotherapy has not yet met expectations. For a long time, exploring safe, effective, economical, and convenient comprehensive treatment plans has been an urgent problem to be solved in the diagnosis and treatment of liver cancer.
The concept of cocktail therapy originated from AIDS treatment. Its principle is to combine drugs with different mechanisms of action to achieve the best therapeutic effect. The drugs in the cocktail therapy for liver cancer are all common drugs that are cheap, have few toxic side effects, and are easy to use.
Professor Xia Jinglin's team has found in more than a decade of clinical practice that intervention combined with cocktail drugs can significantly prolong the survival of advanced liver cancer compared with intervention alone. The one-, two-, and three-year survival rates of the combined cocktail drug group were significantly higher than those of the intervention alone group, at 88.1%, 61.6%, 41.0% and 53.5%, 26.8%, 23.9%, respectively. In addition, cocktail therapy has reduced the cost of treatment for patients to a certain extent, alleviating their financial pressure.
To further reveal the mechanism of action of cocktail therapy for liver cancer, the team conducted research in vivo and in vitro and at the molecular level and found that compared with a single drug or a combination of two drugs, the three-drug cocktail combination can relieve the immunosuppression caused by liver cancer by regulating the SAMD4B-APOA2-PD-L1 axis. In other words, the cocktail drug can reactivate the human immune system to eliminate liver cancer cells.
The review experts fully affirmed the team's research: this study discovered and proposed for the first time the synergistic effect of immunochemotherapy in liver cancer cocktails, which can bring new hope to patients with advanced liver cancer who have lost the opportunity for surgical resection, and has scientific and social value.
Xia Jinglin explained that the liver cancer cocktail therapy is also called the thalidomide-based liver cancer cocktail therapy, which mainly includes three common drugs: thalidomide, carmofur, and compound blister beetle.
Thalidomide was used to stop vomiting during pregnancy in the 1960s. The drug can cause fetuses to have short limbs and be called "seal babies" because it can inhibit fetal vascular development. Because thalidomide has anti-angiogenic effects, it can be used to inhibit tumor angiogenesis and treat tumors. Later studies also found that thalidomide has an immunomodulatory effect, which is equivalent to the dual effects of targeted and immunotherapy. Carmofur is often used for digestive tract tumors; compound blister beetles are Chinese patent medicines for liver cancer.
Experts say that the triple cocktail drugs have different mechanisms of action and can play the role of 111>3. In addition, the side effects of the drugs can offset each other, complement each other's strengths and improve safety. Only a small dose can play a "four ounces to move a thousand pounds" role, and the convenience of oral administration is also more conducive to improving patient compliance and achieving longer survival.