Hepatocellular carcinoma immune microenvironment and check point inhibitors-current status

Core Tip

Core Tip: Hepatocellular carcinoma (HCC) is a prototype of inflammation-associated cancer. Its varied etiology from viral to alcohol and non-alcoholic steatohepatitis, tumor extent, intrahepatic spread, vascular invasion and metastases along with the underlying severity of liver dysfunction make it a complex scenario for adequate management. The recent elaboration of the tumor microenvironment revealing an immunogenic milieu and bringing the concept of “Cold” and “Hot” tumor opened the way for evaluation of immunotherapy in HCC. In recent years, with use of immune checkpoint inhibitors, there is a paradigm shift in the management of advanced and unresectable HCC. With the use of combination regimens including immune checkpoint inhibitors and transarterial chemoembolization/ablation/tyrosine kinase inhibitors, there is an ongoing effort to improve disease outcomes and minimize adverse events.