Immune-Based Combination Therapies for Advanced Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) is the fourth most frequent cause of cancer-related death worldwide. HCC frequently presents as advanced disease at diagnosis, and disease relapse following radical surgery is frequent. In recent years, immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced HCC, particularly with the introduction of atezolizumab/bevacizumab as the new standard of care for first-line treatment. Recently, dual immune checkpoint blockade with durvalumab plus tremelimumab has also emerged as an effective first-line treatment for advanced HCC and most of the research is currently focused on developing combination treatments based mainly on ICIs. In this review, we will discuss the rationale and ongoing clinical trials of immune-based combination therapies for the treatment of advanced HCC, also focusing on new immunotherapy strategies such as chimeric antigen receptor T cells (CAR-T) and anti-cancer vaccines.

Targeted Immunotherapy for Hepatocellular Carcinoma: A Clinical Case

“…The Atezolizumab + Bevacizumab combination is recommended as a first-line standard of care in patients with advanced HCC [6] and was approved by the European Medicines Agency (EMA) at the end of 2020 [7]. Besides, according to the recommendations of the National Comprehensive Cancer Network (NCCN version 2.2023), the Atezolizumab + Bevacizumab combination is a preferred first-line therapy regimen for HCC [8,9].…”

Immune Cytolytic Activity and Strategies for Therapeutic Treatment

“…Despite the fact that ICI therapies have received increased interest, their efficacy alone is restricted by low response rates. Dual ICI constitutes one of the most promising forms of immunotherapy for cancer treatment that enhances the antitumor activity of cytotoxic T cells, and it is already used to treat solid tumors with great efficacy and promising results, including skin melanoma and RCC, as well as advanced HCC [144].…”