Options and survival benefits of conversion therapy for unresectable hepatocellular carcinoma

Abstract

In the study by Wu et al, patients with unresectable hepatocellular carcinoma were subjected to transarterial chemoembolization (TACE) as a conversion therapy in order to render their tumors suitable for resection. A nomogram was devised and shown to be effective in predicting the survival of these patients. Generalization of the results, however, is questionable since the study subjects consisted of patients who had resection after TACE while excluding patients with the same disease but not suitable for TACE. Immunotherapy can be considered to be an option for conversion therapy. However, markers for determining responses to a conversion therapy and for guiding the decision between TACE and sequential immunotherapy have been lacking. The question of whether effective conversion therapy can truly enhance overall survival remains unanswered.

Keywords: Conversion therapy; Immunotherapy; Liver resection; Survival; Transarterial chemoembolization; Unresectable hepatocellular carcinoma

Core Tip: In addition to transarterial chemoembolization (TACE), immunotherapy should also be among the options for conversion therapy for rendering unresectable hepatocellular carcinoma suitable for resection. For patients unsuitable for TACE, immunotherapy can be an alternative.