Immunotherapies for advanced hepatocellular carcinoma

Area of Science:

• Oncology
• Immunology

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer death in China, often diagnosed at unresectable stages.
• Advanced HCC historically had limited treatment options, with sorafenib as the sole tyrosine kinase inhibitor (TKI) since 2008.
• Chemotherapy resistance and lack of early symptoms contribute to poor prognosis in HCC.

Purpose of the Study:

• To review current immunotherapies for advanced hepatocellular carcinoma (HCC).
• To summarize immune-related adverse events (irAEs) associated with immunotherapies.
• To provide references for clinical application and further research on HCC immunotherapies and irAE management.

Main Methods:

• Literature review of current immunotherapies for HCC.
• Analysis of immune checkpoint inhibitors (ICIs) including PD-1, PD-L1, and CTLA-4 inhibitors.
• Examination of ICI-based combination therapies and their clinical trial status.
• Review of reported immune-related adverse events (irAEs) and their management strategies.

Main Results:

• Immune checkpoint inhibitors (ICIs) demonstrate significant anti-tumor effects in HCC.
• Various ICIs (nivolumab, pembrolizumab, atezolizumab, ipilimumab) are being investigated, often in combination with TKIs or other agents.
• Immune-related adverse events (irAEs), such as cutaneous, gastrointestinal, and hepatic toxicities, are a critical consideration.

Conclusions:

• Immunotherapies, particularly ICIs, represent a promising advancement in HCC treatment.
• Effective management of irAEs is crucial for the safe and continued application of ICIs in HCC patients.
• Further research into ICI-based therapies and irAE mitigation is warranted for improved clinical outcomes.