Interventional Oncology Meets Immuno-oncology: Combination Therapies for Hepatocellular Carcinoma
Ryan Bitar1, Riad Salem1, Richard Finn1
1From the Departments of Radiology (R.B., J.C.) and Digestive Diseases (Hepatology) (J.C.), Yale University School of Medicine, New Haven, Conn; Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill (R.S.); Department of Medical Oncology, Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif (R.F.); Center for Cancer Research, National Institutes of Health, Bethesda, Md (T.F.G.); Department of Radiology, Hadassah Hebrew University Medical Center, Hebrew University, Jerusalem, Israel (S.N.G.); and Department of Biomedical Engineering, Yale School of Engineering and Applied Sciences, 789 Howard Ave, Clinic Bldg 363H, New Haven, CT 06520 (J.C.).
Abstract:
The management of hepatocellular carcinoma (HCC) is undergoing transformational changes due to the emergence of various novel immunotherapies and their combination with image-guided locoregional therapies. In this setting, immunotherapy is expected to become one of the standards of care in both neoadjuvant and adjuvant settings across all disease stages of HCC. Currently, more than 50 ongoing prospective clinical trials are investigating various end points for the combination of immunotherapy with both percutaneous and catheter-directed therapies. This review will outline essential tumor microenvironment mechanisms responsible for disease evolution and therapy resistance, discuss the rationale for combining locoregional therapy with immunotherapy, summarize ongoing clinical trials, and report on developing imaging end points and novel biomarkers that are relevant to both diagnostic and interventional radiologists participating in the management of HCC.
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