Current status and perspectives of immune-based therapies for hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) is a frequent cancer with a high mortality. For early stage cancer there are potentially curative treatments including local ablation, resection and liver transplantation. However, for more advanced stage disease, there is no optimal treatment available. Even in the case of a "curative" treatment, recurrence or development of a new cancer in the precancerous liver is common. Thus, there is an urgent need for novel and effective (adjuvant) therapies to treat HCC and to prevent recurrence after local treatment in patients with HCC. The unique immune response in the liver favors tolerance, which remains a genuine challenge for conventional immunotherapy in patients with HCC. However, even in this "immunotolerant" organ, spontaneous immune responses against tumor antigens have been detected, although they are insufficient to achieve significant tumor death. Local ablation therapy leads to immunogenic tumor cell death by inducing the release of massive amounts of antigens, which enhances spontaneous immune response. New immune therapies such as dendritic cell vaccination and immune checkpoint inhibition are under investigation. Immunotherapy for cancer has made huge progress in the last few years and clinical trials examining the use of immunotherapy to treat hepatocellular carcinoma have shown some success. In this review, we discuss the current status of and offer some perspectives on immunotherapy for hepatocellular carcinoma, which could change disease progression in the near future.

Is Adjuvant Cellular Immunotherapy Essential after TACE-Predominant Minimally-Invasive Treatment for Hepatocellular Carcinoma? A Systematic Meta-Analysis of Studies Including 1774 Patients

“…It has been reported that cellular immunotherapy could strengthen the immune state and afford a potential value in enhancing the therapeutic outcome [13], although it has not been considered as a standard therapy for HCC. Several studies and meta-analysis had revealed that the combination of cellular immunotherapy of conventional therapies was more effective [14,15].…”

BCLC-B hepatocellular carcinoma treatment or when should the systemic therapy be started

“…Один из возможных механизмов противоопухолевого эффекта интервенци-онного воздействия -иммунокомпетентная гибель опу-холевой клетки [12]. Локальный некроз и гибель опухоле-вых клеток приводят к неспецифической (высвобожде-ние большого количества «сигналов опасности» или т.н.…”

Systemic treatment for hepatocellular carcinoma: Still unmet expectations

“…This may hampers an effective immune response against cancer cells[78]. Moreover this is a challenge on the use of conventional immunotherapy is challenged.…”