Published online Mar 14, 2021. doi: 10.3748/wjg.v27.i10.919
Peer-review started: January 5, 2021
First decision: January 17, 2021
Revised: January 29, 2021
Accepted: February 28, 2021
Article in press: February 28, 2021
Published online: March 14, 2021
Processing time: 65 Days and 0.2 Hours
In the immune oncology era, the clinical efficacy of immune checkpoint inhibitors (ICIs) against most solid cancers is well known. In hepatocellular carcinoma, the recent success of combination therapy with targeting agents has accelerated the search for novel combination strategies. Radiotherapy (RT), an attractive modality, can be combined with ICIs, which act as strong modulators of the tumor immune microenvironment. Herein, we discuss immune modulation caused by radiation and the current trials of RT–ICI combination treatment as well as future perspectives.
Core Tip: Immune modulatory effect of radiation is highlighted as a combination strategy with immune checkpoint inhibitors. This strategy has been actively adopted in most solid cancers. Although it is in relatively early stage for hepatocellular carcinoma, accumulated evidence drives clinical trials on testing its efficacy. Still, there remain several challenges to overcome for the best oncologic outcome.