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Updated: Jun 7, 2025
Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
Promising PD-1 antagonists for liver cancer: an evaluation of phase II and III results
Leonardo Stella1,2, Clemence Hollande3, Yasmina Ben Merabet3
1Digestive Disease Center (CEMAD), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Introduction:
Hepatocellular carcinoma (HCC), the most common primary liver cancer, is a major cause of cancer-related morbidity and mortality. Limited treatment options for advanced stages highlight the need for effective therapies.
Areas Covered:
This review explores immune checkpoint inhibitors (ICIs), specifically PD-1, PD-L1, and CTLA-4 inhibitors, as emerging treatments for advanced HCC. It discusses data from phase II and III trials evaluating ICI combinations with tyrosine kinase inhibitors (TKIs), anti-angiogenic agents, and locoregional treatments like Transarterial Chemoembolization (TACE). Clinical outcomes, including progression-free survival and response rates, were analyzed alongside the incidence and management of immune-related adverse events (irAEs). A systematic review approach ensured comprehensive, high-quality study inclusion.
Expert Opinion:
ICI-based therapies and their combinations are transforming advanced HCC treatment, offering improved outcomes and potential survival benefits. However, these therapies need optimization in sequencing and selection, particularly considering variations in liver function and disease stage. Effective management of adverse effects is critical to maximize clinical benefits. Further research is required to develop personalized strategies, tailoring treatments to patient-specific factors and enhancing safety and effectiveness in HCC management.
Insights
Immune checkpoint inhibitors (ICIs) show promise for advanced hepatocellular carcinoma (HCC) treatment. Optimizing ICI combinations and managing side effects are key for improving patient survival and outcomes in liver cancer.
Area of Science:
- Oncology
- Immunotherapy
- Hepatocellular Carcinoma Research
Background:
- Hepatocellular carcinoma (HCC) presents a significant global health challenge, with limited effective treatments for advanced stages.
- The need for novel therapeutic strategies to improve outcomes in advanced HCC is critical.
Purpose of the Study:
- To review the emerging role of immune checkpoint inhibitors (ICIs) in treating advanced HCC.
- To analyze clinical trial data on ICI combinations and their impact on patient outcomes and adverse events.
Main Methods:
- Systematic review of phase II and III clinical trials.
- Analysis of immune checkpoint inhibitors (PD-1, PD-L1, CTLA-4) and their combinations.
- Evaluation of clinical outcomes (progression-free survival, response rates) and immune-related adverse events (irAEs).
Main Results:
- ICI-based therapies, including combinations with tyrosine kinase inhibitors (TKIs) and anti-angiogenic agents, demonstrate improved outcomes in advanced HCC.
- Transarterial Chemoembolization (TACE) in combination with ICIs is also explored.
- Management of immune-related adverse events (irAEs) is crucial for maximizing treatment benefits.
Conclusions:
- Immune checkpoint inhibitors (ICIs) are transforming advanced HCC treatment, offering survival benefits.
- Further research is needed to optimize ICI sequencing, patient selection based on liver function and disease stage, and personalized treatment strategies.
- Effective management of irAEs is essential for enhancing the safety and efficacy of ICI therapies in HCC.
