ArticleAnnals of medicine and surgery (2012)2026
Perioperative camrelizumab plus rivoceranib in resectable hepatocellular carcinoma: translating CARES-009 outcomes into a new therapeutic paradigm.
Article in Annals of medicine and surgery (2012), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most common causes of malignancy, and recurrence rates are 50-70% even with curative resection, which indicates the necessity to employ an efficient perioperative systemic treatment. Aim: To conclude, regarding the mechanistic rationale and clinical evidence for perioperative camrelizumab (PD-1 inhibitor) and rivoceranib (VEGFR2 inhibitor) in resectable HCC, it is crucial to review CARES-009 and related information to inform clinical practice and research priorities. Results: Camrelizumab overturns T-cell exhaustion, whereas rivoceranib normalizes tumor vasculature and alleviates hypoxia, creating immuno-angiogenic synergy. In CARES-009, perioperative camrelizumab combined with rivoceranib was superior to surgery for event-free survival and primary pathological response in intermediate/high-risk resectable HCC. The favorable antitumor activity and favorable safety profile are supported by evidence from CARES-310 and other immunotherapy-TKI trials in advanced HCC. Translational research demonstrates that immune-angiogenic signatures and circulating tumor DNA can be used to risk-stratify. However, existing evidence is scarce due to poor overall survival outcomes, cohorts mostly driven by hepatitis B virus, and various regional differences in costs and access to drugs. Conclusion: Perioperative camrelizumab plus rivoceranib is a biologically rational and clinically promising agent that can be used to decrease recurrence in high-risk patients who have undergone resection of HCC. Nevertheless, these should be routinely introduced once mature survival, biomarker, real-world, and economic data are available. Once again, current use is best utilized in clinical trials or structured registry models.
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