Immune checkpoint inhibitors in liver transplantation: Current practice, challenges, and opportunities

Abstract

Immune checkpoint inhibitors are becoming a mainstay of cancer treatment. While first studied and approved for patients with unresectable disease, due to their efficacy they are becoming increasingly used in the perioperative period across many cancer types. In patients with hepatocellular carcinoma (HCC), immune checkpoint inhibitors have now become standard of care in the advanced setting and have shown promising results in the adjuvant setting after liver resection. While these drugs continue to show promise, their role in the peritransplant setting still remains a question. In this review we explore the current use of this class of medications in patients with HCC, as well as the immunologic role of the pathways that they inhibit. We also identify potentials for future research opportunities to better understand the role of these medications.