Thermal ablation and immunotherapy for hepatocellular carcinoma: Recent advances and future directions

Abstract

Hepatocellular carcinoma (HCC) is one of most common cancers that cause death in the world. Thermal ablation (TA) is an important alternative treatment method for HCC patients who are not appropriate for surgery or liver transplantation. Particularly for small and early HCCs, TA can be considered as the first-line curative treatment. However, local and distant recurrence rates are still high even though the TA equipment and technology develop rapidly. Immunotherapy is a novel systemic treatment method to enhance the anti-tumor immune response of HCC patients, which has the potential to reduce the tumor recurrence and metastasis. The combination of local TA and systemic immunotherapy for HCCs may be an ideal treatment for enhancing the efficacy of TA and controlling the recurrence. Herein we summarize the latest progress in TA, immunotherapy, and their combination for the treatment of patients with HCC and discuss the limitations and future research directions of the combined therapy.

Keywords: Hepatocellular carcinoma; Thermal ablation; Radiofrequency ablation; Immunotherapy; Recurrence; Anti-tumor immune response

Core Tip: Hepatocellular carcinoma (HCC) is one of the most leading causes of death in the world. Thermal ablation (TA) is an important treatment method for HCC patients. The main disadvantage of TA for HCC is the high local and distant recurrence rates after treatment. Immunotherapy is a novel systemic treatment that presents potential efficacy to inhibit the tumor recurrence. The combination of local TA and immunotherapy for HCC may be an ideal treatment for enhancing the efficacy of TA and controlling the recurrence. We herein summarize the latest progress in TA, immunotherapy, and the combination of TA with immunotherapy for HCC and discuss the future directions of the combined therapy.