Combining irreversible electroporation and immunotherapy for hepatocellular carcinoma: Reflections and directions for advancement

Abstract

We read with great interest the recent article by Xing et al, which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model. The study offers valuable mechanistic insights into local ablation, enhancing the efficacy of immune checkpoint blockade. However, critical methodological limitations and an overstatement of mechanistic conclusions warrant cautious interpretation. We recommend clarifying experimental details, optimizing murine models, applying more robust statistical analyses, and tempering conclusions to reflect the correlative nature of the findings. Further work should investigate immune mechanisms, durability of response, and safety in clinically relevant models to maximize translational potential. These refinements will strengthen the study’s impact in advancing ablation-immunotherapy strategies in hepatocellular carcinoma.

Keywords: Irreversible electroporation; Anti-programmed death-1 therapy; Hepatocellular carcinoma; Tumor immunology; Immune checkpoint blockade; Murine cancer model; Translational oncology

Core Tip: A recent study by Xing et al explored how combining a special tumor treatment called irreversible electroporation with a type of immunotherapy (anti-programmed death-1) can help the immune system fight liver cancer in mice. While the results are promising, the study requires clearer explanations of how and where samples were collected, more effective use of statistical methods, and a cautious interpretation of the findings. Future studies should use models more similar to human liver cancer and test long-term effects and safety to understand the treatment’s potential for patients.