The oncologist spoke about the risks and limitations of immunotherapy for liver cancer

The treatment regimen "immunotherapy + surgery" shows the greatest effectiveness in a strictly defined group of patients, primarily with hepatocellular carcinoma (HCC). This was announced to Izvestia on April 23 by oncologist, oncosurgeon, chairman of the oncological council of JSC "Medicine" (Academician Roitberg clinic) Ruslan Basanov.

According to the specialist, the best results are observed in patients with preserved liver function (Child-Pugh class A or B), satisfactory general condition (0-1 ECOG score), as well as localized or potentially resectable tumors. In such cases, immunotherapy can reduce the size of the lesion and make subsequent surgical intervention possible.

In addition, this approach can be used in patients who do not require liver transplantation, but who still have a chance of resection after responding to treatment. In some situations, the scheme is used as a "bridge therapy" before an organ transplant.

"At the same time, there are categories of patients for whom such therapy is not suitable. These are, in particular, patients with decompensated cirrhosis (Child-Pugh class C), severe portal hypertension, severe vascular invasion, extrahepatic metastases, as well as patients with poor functional status (ECOG ≥2) and active autoimmune diseases. In these cases, immunotherapy can not only fail to have an effect, but also lead to serious complications," the expert explained.

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Injections complement standard therapy, forming a comprehensive approach to cancer treatment.

Basanov also noted that immunotherapy can influence surgical treatment and recovery. Possible complications include immune reactions such as colitis, hepatitis, endocrine disorders, and pneumonitis, which require special monitoring. Patients with cirrhosis also have an increased risk of worsening liver failure and bleeding.

According to the specialist, in Russia, similar treatment regimens are available in federal and large regional cancer centers, where multidisciplinary teams work. However, their use is limited by a number of factors. Among them are the high cost of modern immunopreparations, not always full coverage due to compulsory medical insurance, as well as uneven availability of therapy in the regions.

The decision on the appointment of the scheme is made only in consultation after a comprehensive examination of the patient, taking into account the stage of the disease, liver function and general condition.

"The "immunotherapy + surgery" scheme is a promising but strictly selective treatment method that requires an individual approach and careful selection of patients," Basanov emphasized.

Oncologist Evgeny Cheremushkin on March 12 called stomach cancer one of the most common types of the disease. According to him, it can be difficult to detect stomach cancer, since its signs are often disguised as other gastrointestinal diseases. The specialist urged to consult a doctor in a timely manner for pain, heartburn or other digestive problems.