Hepatocellular carcinoma and immunotherapy: Beyond immune checkpoint inhibitors

Abstract

Hepatocellular carcinoma (HCC) is one of the deadliest and most common malignancies of the liver. Considering the rich immune background of carcinogenesis in HCC, efforts have been focused on further understanding the role of the immune system in tumor suppression and promotion. The utilization of immunotherapy in HCC has led to encouraging results that has translated to longer survival and better quality of life among patients. The development of novel HCC-tailored regimens such as vaccine therapy and adoptive cellular therapy coupled with a deeper understanding of biomarkers predictive of the response to immunotherapy will lead to better treatment outcomes.

Keywords: Hepatocellular carcinoma; Immunotherapy; Biomarkers; Cancer vaccines; Adoptive cellular therapy

Core Tip: Immunotherapy has changed the treatment landscape for solid cancers. In advanced hepatocellular carcinoma (HCC), immune checkpoint inhibitors have become the standard of care due to their efficacy and safety outcomes. However, primary and acquired resistance is a major issue in the treatment paradigm, and more research is still needed to understand and identify potential predictors of the response in HCC. Other immunotherapy modalities, such as vaccine therapy and adoptive cellular therapy, could play a prominent role in certain HCC subcohorts and are currently being investigated in clinical trial settings.