Advances in immunotherapy for hepatocellular carcinoma

Area of Science:

• Oncology
• Immunology
• Hepatology

Background:

• Hepatocellular carcinoma (HCC) progression is influenced by the immune system.
• Systemic therapy for advanced HCC historically relied on antiangiogenic tyrosine kinase inhibitors (TKIs).
• Immunotherapy, particularly checkpoint inhibitors, has emerged as a significant treatment modality.

Purpose of the Study:

• To review current immunotherapies for HCC.
• To discuss emerging therapeutic strategies and challenges in HCC immunotherapy.
• To provide an update on the optimal use of available immunotherapies and future directions.

Main Methods:

• Review of current literature on HCC immunotherapy.
• Analysis of clinical trial data for approved and investigational agents.
• Discussion of challenges and future opportunities in HCC treatment.

Main Results:

• Combination of atezolizumab (anti-PDL1) and bevacizumab (anti-VEGF) is becoming a first-line standard for HCC.
• Anti-PD1 agents (nivolumab, pembrolizumab) are used post-TKI therapy in some regions.
• Other immune strategies like T-cell transfer, vaccination, and virotherapy lack consistent clinical activity.

Conclusions:

• Significant unmet needs remain, including predictive biomarker discovery and application in patients with liver dysfunction.
• Combinatorial and sequential approaches with systemic or local treatments are highly promising.
• Ongoing clinical trials are evaluating novel therapeutic strategies for HCC.