medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-256medsovet-9250Research ArticleИММУНОТЕРАПИЯIMMUNOTHERAPYСлучай длительной терапии гепатоцеллюлярной карциномы комбинацией «бевацизумаб и атезолизумаб»A case of long-term therapy of hepatocellular carcinoma with atezolizumab and bevacizumab combinationhttps://orcid.org/0000-0003-3734-2779МеньшиковК. В.MenshikovK. V.

Меньшиков Константин Викторович, к.м.н., доцент кафедры онкологии и клинической морфологии, Башкирский государственный медицинский университет; врач-онколог отдела химиотерапии, Республиканский клинический онкологический диспансер

450008, Уфа, ул. Ленина, д. 3; 450054, Уфа, проспект Октября, д. 73/1

Konstantin V. Menshikov, Cand. Sci. (Med.), Associate Professor of the Department of Oncology with Courses in Oncology and Pathological Anatomy, Institute of Continuing Professional Education, Bashkir State Medical University;  Oncologist of the Department of Chemotherapy, Republican Clinical Oncology Dispensary

3, Lenin St., Ufa, 450008; 73/1, Oktyabrya Ave., Ufa, 450054

kmenshikov80@bk.ruhttps://orcid.org/0000-0003-0996-5995СултанбаевА. В.SultanbaevA. V.

Султанбаев Александр Валерьевич, к.м.н., доцент кафедры педагогики и психологии, Башкирский государственный медицинский университет; заведующий отделом противоопухолевой лекарственной терапии, Республиканский клинический онкологический диспансер

450008, Уфа, ул. Ленина, д. 3; 450054, Уфа, проспект Октября, д. 73/1

 

Alexander V. Sultanbaev, Cand. Sci. (Med.), Associate Professor of the Department of Pedagogy and Psychology, Bashkir State Medical University; Head of the Department of Antitumor Drug Therapy, Republican Clinical Oncology Dispensary

3, Lenin St., Ufa, 450008; 73/1, Oktyabrya Ave., Ufa, 450054

rkodrb@yandex.ruhttps://orcid.org/0000-0003-1185-977XМусинШ. И.MusinSh. H.

Мусин Шамиль Исмагилович, к.м.н., заведующий хирургическим отделением опухолей «голова – шея»

450054, Уфа, проспект Октября, д. 73/1

Shamil I. Musin, Cand. Sci. (Med.), Head of the Surgical Department of Head and Neck Tumors

73/1, Oktyabrya Ave., Ufa, 450054

musin_shamil@mail.ruhttps://orcid.org/0009-0008-4620-120XВалишинВ. А.ValishinV. A.

Валишин Вадим Аликович, врач-онколог хирургического отделения №1

450054, Уфа, проспект Октября, д. 73/1

Vadim A. Valishin, Oncologist, Surgical Department No. 1

73/1, Oktyabrya Ave., Ufa, 450054

МеньшиковаИ. А.Men′shikovaI. A.

Меньшикова Ирина Асхатовна, к.м.н., доцент, доцент кафедры биологической химии

450008, Уфа, ул. Ленина, д. 3

Irina A. Men′shikova, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Biological Chemistry

3, Lenin St., Ufa, 450008

https://orcid.org/0000-0001-8779-4074ЧаловВ. С.ChalovV. S.

Чалов Виталий Сергеевич, заведующий отделением радиотерапии, врач-радиотерапевт

450008, Уфа, ул. Рихарда Зорге, д. 58, стр. 2

Vitaliy S. Chalov, Head of the Radiotherapy Department, Radiotherapist

Bldg. 2, Richard Sorge St., Ufa, 450008

v.chalov@pet-net.ruhttps://orcid.org/0000-0001-5926-0446СултанбаеваН. И.SultanbaevaN. I.

Султанбаева Надежда Ивановна, врач-онколог отделения противоопухолевой лекарственной терапии №1

450054, Уфа, проспект Октября, д. 73/1

Nadezda I. Sultanbaeva, Oncologist, Department of Antitumor Drug Therapy No. 1

73/1, Oktyabrya Ave., Ufa, 450054

nd.sultan@rambler.ruhttps://orcid.org/0000-0002-5871-5151ГалимовШ. Н.GalimovSh. N.

Галимов Шамиль Нариманович, д.м.н., профессор, заведующий кафедрой биологической химии

450008, Уфа, ул. Ленина, д. 3

Shamil N. Galimov, Dr. Sci. (Med.), Professor, Head of the Department of Biological Chemistry

3, Lenin St., Ufa, 450008

Башкирский государственный медицинский университет; Республиканский клинический онкологический диспансерРоссияBashkir State Medical University; Republican Clinical Oncology DispensaryRussian FederationРеспубликанский клинический онкологический диспансерРоссияRepublican Clinical Oncology DispensaryRussian FederationБашкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian FederationЦентр ядерной медицины «ПЭТ-Технолоджи»РоссияPET-Technology Nuclear Medicine CentreRussian Federation2025300720250104954Copyright © Меньшиков К.В., Султанбаев А.В., Мусин Ш.И., Валишин В.А., Меньшикова И.А., Чалов В.С., Султанбаева Н.И., Галимов Ш.Н., 20252025Меньшиков К.В., Султанбаев А.В., Мусин Ш.И., Валишин В.А., Меньшикова И.А., Чалов В.С., Султанбаева Н.И., Галимов Ш.Н.Menshikov K.V., Sultanbaev A.V., Musin S.H., Valishin V.A., Men′shikova I.A., Chalov V.S., Sultanbaeva N.I., Galimov S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9250

Гепатоцеллюлярная карцинома является наиболее распространенным первичным злокачественным новообразованием печени, на долю которого приходится более 90% случаев. До внедрения таргетной терапии опций в лечении нерезектабельной ГЦК практически не было. В настоящее время сорафениб и ленватиниб зарегистрированы в качестве первой линии терапии нерезектабельного ГЦК. Внедрение в практику комбинации атезолизумаба и бевацизумаба значительно улучшило результаты лечения ГЦК. В исследовании IMbrave 150 медиана ОВ составила 19,2 мес. в группе атезолизумаба и бевацизумаба и 13,4 мес. в группе сорафениба. Медиана выживаемости без прогрессирования составила 6,9 и 4,3 соответственно. В приведенном клиническом наблюдении описан случай лечения пациента с нерезектабельной ГЦК, большой опухолевой нагрузкой и тромбозом ветви воротной ветви. В первой линии терапии мы рассмотрели комбинацию атезолизумаба и бевацизумаба. Получен быстрый ответ на проводимую терапию, зарегистрирован полный ответ после 42 мес. терапии комбинацией атезолизумаба и бевацизумаба. Отмечено минимальное количество нежелательных явлений, удовлетворительная переносимость. В настоящее время пациент продолжает терапию данной комбинацией. В настоящее время все большее количество пациентов получают терапию атезолизумабом и бевацизумабом длительное время. Накапливается опыт в реальной клинической практике наблюдения за пациентами, длительно получающими комбинацию иммуноонкологического и таргетного препаратов.

Hepatocellular carcinoma is the most common primary malignant neoplasm of the liver, accounting for more than 90% of cases. Before the introduction of targeted therapy, there were virtually no options for the treatment of unresectable HCC. Currently, sorafenib and lenvatinib are registered as first-line therapy for unresectable HCC. The introduction of the combination of atezolizumab and bevacizumab has significantly improved the results of HCC treatment. In the IMbrave 150 study, the median OS was 19.2 months in the atezolizumab and bevacizumab group and 13.4 months in the sorafenib group. The median progression-free survival was 6.9 and 4.3, respectively. The presented clinical observation describes a case of treatment of a patient with unresectable HCC, a large tumor burden and portal vein thrombosis. In the first line of therapy, we considered the combination of atezolizumab and bevacizumab. A rapid response to the therapy was obtained, a complete response was registered after 42 months of therapy with a combination of atezolizumab and bevacizumab. A minimum number of adverse events and satisfactory tolerability were noted. Currently, the patient continues therapy with this combination. Currently, an increasing number of patients receive therapy with atezolizumab and bevacizumab for a long time. Experience is accumulating in real clinical practice of monitoring patients who have been receiving a combination of immunooncologic and targeted drugs for a long time.

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The authors declare that there are no conflicts of interest present.