编者按：香江潮涌，智慧如澜。第19届国际肝癌协会（ILCA）年会于2025年11月19日在中国香港隆重启幕，汇聚全球肝癌领域顶尖学者，共绘肝癌防治新蓝图。本次年会不仅是ILCA自2017年以来首次重返亚洲舞台，更聚焦肝癌全程管理、区域差异、治疗可及性与精准医疗等核心议题。《国际肝病》与《肿瘤瞭望》奔赴现场，特邀ILCA现任主席、英国伦敦大学学院皇家自由医院Tim Meyer教授进行专访。Tim Meyer教授从大会亮点、全球协作、资源公平与科研前沿等多维度展开探讨，言语间既见学术之严谨，亦含人文之关切。在此，我们谨将访谈精华整理成文，与读者共同学习探讨，期待能为中国肝癌领域的临床实践与科研探索注入新的视角与动力。

 

01

非常感谢您在2025年ILCA年会上接受我们的采访。我们了解到，这是自2017年以来，大会首次重返亚洲。能否请您结合本次会议的核心主题，分享最值得关注的亮点？

 

Thank you very much for accepting our interview at the ILCA Annual Conference 2025.As we know，this is the first time it has returned to Asia since 2017.Based on the core themes of the meeting，could you share the key highlights that deserve the most attention?

 

Tim Meyer教授：ILCA年会的内容设计非常全面，涵盖了肝癌从预防、早期检测到治疗的全过程。近年来，我们在继续聚焦肝细胞癌的同时，对胆管癌的关注度也在不断提升。ILCA此前的核心关注领域以肝细胞癌为主，而现在胆管癌逐渐成为会议中日益重要的组成部分。正如我刚才提到的，我们致力于覆盖肝癌诊疗的各个方面，因此会议也吸引了来自外科、肝病科、放射科、病理科及肿瘤科等多学科专家的共同参与。

 

Prof.Tim Meyer:The ILCA meeting is a very comprehensive conference covering every aspect of liver cancer，from prevention and early detection through to treatment.In recent years，we have also placed increasing emphasis on cholangiocarcinoma.Formerly，ILCA was largely focused on hepatocellular carcinoma，but cholangiocarcinoma is now becoming an increasingly important part of the program.As I mentioned，we aim to cover all aspects of management，bringing together surgeons，hepatologists，radiologists，pathologists，and oncologists to participate.

 

02

肝癌在不同地区的病因、分型以及人群特征存在显著差异。ILCA如何促进全球多中心研究，以更好地理解与解决这些区域差异？

 

HCC exhibits significant differences in its etiology，subtypes，and population characteristics across different regions.How does ILCA promote global multicenter studies to better understand and address these regional disparities?

 

Tim Meyer教授：这确实是一个关键问题。正如您指出的，肝癌的病因在全球范围内确实存在显著差异。在亚洲尤其是中国，乙型肝炎是导致肝癌的主要致病因素；而在西方人群中，脂肪性肝病引发的肝癌占比更高。目前，我们尚无充分证据表明治疗效果会因病因而存在显著差异，但开展全球性试验的重要性不言而喻。

 

当前面临的一大挑战在于，若大型临床试验仅在中国开展，其结论可能被认为不能直接推广至全球其他地区。但需注意的是，这类大型试验通常由制药公司主导发起，研究者们对试验开展地点的主导权相对有限。尽管如此，ILCA一直积极与制药企业保持沟通，并持续向他们强调：开展具有包容性的全球试验，而非区域性试验，是十分必要的。

 

Prof.Tim Meyer:I think that is an important question.As you rightly say，the etiology varies significantly around the globe.In Asia and China，hepatitis B is the dominant driver，whereas in Western populations，the disease is more often driven by fatty liver disease.At the moment，we do not have strong evidence showing that treatments work significantly better or worse depending on different etiologies.Nevertheless，we believe it is important to conduct trials in a global context.One of the challenges is that when very large trials are conducted exclusively in China，the results are sometimes not considered applicable to the rest of the world.However，these large trials are usually driven by pharmaceutical companies as sponsors，and therefore academics may not have a major influence on where the studies are conducted.ILCA does，however，engage with pharmaceutical companies，and we make our views clear regarding the importance of inclusive，globally representative clinical trials rather than regional ones.

 

03

近年来肝癌的治疗选择和治疗组合越来越多。在您看来，在应用这些最新方案时，经济欠发达地区的肝癌中心与医疗体系更发达的地区之间存在哪些主要差距？我们如何努力缩小这一差距？

 

In recent years，there have been many new treatment options and therapeutic combinations for liver cancer.In your view，what are the major gaps between liver cancer centers in economically less-developed regions and those in more advanced healthcare systems when it comes to adopting these latest approaches?And how can we work toward narrowing this gap?

 

Tim Meyer教授：确实如此。我认为，基于各个国家收入水平的不同，各地区在应用最新治疗方案方面存在显著差距。近期，《柳叶刀》杂志发表了一篇由ILCA部分成员撰写的论文，就专门探讨了这一议题，其中重点关注了不同地区在全身性治疗可及性上的差距，这类治疗方案的费用通常十分高昂。

 

为此，ILCA正尝试通过其倡导委员会来应对这一挑战。我们积极与患者团体、政策制定者、政府部门以及制药行业进行沟通，旨在共同推动加快治疗的可及性进程。因为这一问题不仅关乎“能否获得”治疗，更关乎“获得速度”。例如，在美国，患者获得新药准入的速度通常远快于欧洲，因为欧洲可能需要经过多轮批准程序。因此，我们的目标是既要加速这一进程，也要确保这些治疗方法在其应用的国家具备可负担的成本效益。

 

Prof.Tim Meyer:I think there are very significant disparities that relate directly to a country’s economic status.A recent paper published in The Lancet by some ILCA members examined this issue，particularly the differences in access to systemic therapies，which are often very costly.ILCA is attempting to address these challenges through its advocacy committee.We work with patient groups，advocacy organizations，policymakers，governments，and the pharmaceutical industry to accelerate access.

 

The issue is not only whether patients can access new therapies，but also how quickly they can access them.For example，in the United States，patients often receive access much more rapidly，while in Europe there may be multiple approval processes that delay availability.Therefore，we are focused both on speeding up access and ensuring that treatments are cost-effective and appropriate for each country’s healthcare environment.

 

04

精准医疗为肝癌治疗带来新机遇的同时，也面临靶点筛选、耐药管理等挑战。您认为未来该领域的研究重点应聚焦哪些方向？

 

While precision medicine brings new opportunities for HCC treatment，it also faces challenges such as target selection and drug resistance management.In your opinion，what should be the future priorities for research in this field?

 

Tim Meyer教授：肝细胞癌的情况相对特殊，尤其是与胆管癌相比存在明显差异。在肝细胞癌领域，我们至今尚未发现可作为致病驱动因素且能被药物靶向的分子靶点；而胆管癌的情况则截然不同，既往研究已在该癌种中发现了可被靶向的突变位点。

 

因此，当前我们的核心研究仍聚焦于两个关键方向：一是明确肝细胞癌的最优治疗靶点，二是探索能否针对这些潜在靶点开发出特异性治疗药物。从这个角度来看，肝细胞癌在精准治疗领域的发展确实还明显滞后于胆管癌。

 

Prof.Tim Meyer:Hepatocellular carcinoma is somewhat unusual，especially when compared with cholangiocarcinoma.In HCC，we have not yet identified clear molecular driver targets that can be effectively addressed with specific drugs.This is different from cholangiocarcinoma，where identifiable mutations exist and can be targeted therapeutically.We are still working to understand what the optimal targets are and whether specific drugs can be developed against them.At present，hepatocellular carcinoma is still quite a long way behind in this regard.