Systemic therapy for hepatocellular carcinoma (HCC) has undergone substantial advancements. With the advent of atezolizumab plus bevacizumab (ATZ/BEV) combination therapy, followed by durvalumab plus tremelimumab, the era of immunotherapy for HCC has commenced. The emergence of systemic treatment with high response rates has led to improvements in overall survival while enabling conversion to radical surgical resection in some patients with HCC. In patients with intermediate-stage HCC, new treatment strategies combining systemic treatment and transcatheter arterial chemoembolization (TACE) are under development in clinical trials. Moreover, the addition of local therapies, such as TACE, to systemic treatment according to the treatment effect could achieve a certain percentage of complete response. In the IMbrave050 trial, the efficacy of ATZ/BEV combination therapy was validated in patients predicted to have a high risk of recurrence, especially in those who had undergone radical surgery or radiofrequency ablation for HCC. Therefore, systemic treatment for HCC is entering a new phase for all disease stages. The objective of this review is to organize the current position of systemic therapy for each HCC stage and discuss the development of new treatment methods and strategies, with a focus on regimens incorporating immune checkpoint inhibitors, along with future prospects.
肝细胞癌（HCC）的系统治疗已取得显著进展。随着阿特珠单抗联合贝伐珠单抗（ATZ/BEV）疗法以及度伐利尤单抗联合替西木单抗疗法的问世，HCC的免疫治疗时代已经开启。高应答率系统治疗方案的出现不仅改善了患者总生存期，还使得部分HCC患者得以转化为根治性手术切除。针对中期HCC患者，结合系统治疗与经导管动脉化疗栓塞（TACE）的新型治疗策略正在临床试验中不断发展。此外，根据治疗效果在系统治疗基础上联合TACE等局部治疗手段，可获得一定比例的完全缓解率。IMbrave050试验证实了ATZ/BEV联合疗法对预测高复发风险患者的疗效，特别是在接受过根治性手术或射频消融治疗的HCC患者中。因此，针对各疾病分期的HCC系统治疗正在迈入新阶段。本综述旨在梳理当前各分期HCC系统治疗的现状，重点探讨以免疫检查点抑制剂为核心的治疗方案及其未来发展方向，并对新型治疗方法和策略的进展进行论述。
肿瘤(癌症)患者之家