PREVALENCE of hepatocellular carcinoma (HCC) is rising, particularly in Western countries, and recent research has shown that a new treatment modality has the potential to transform care for patients with HCC. Traditional treatment options vary depending on tumour characteristics and patient health, and include liver transplantation, surgical resection, percutaneous ablation, trans-arterial chemoembolization (TACE), and radio-embolization.
The researchers, led by Hongbin Wei, Lanzhou University, Lanzhou, Gansu, China, explored the ways in which immune checkpoint inhibitors (ICI) have revolutionized cancer treatment, including for HCC, and explained that using them in combination with other therapies could offer new hope for patients with HCC. Combining ICIs with targeted therapies, such as kinase inhibitors or angiogenesis inhibitors, has shown promise in treating HCC, Wei and colleagues explained. These combinations aim to disrupt tumour growth pathways and improve immune cell infiltration into the TME, enhancing the efficacy of ICIs. Studies demonstrate that these combinations can improve overall survival and progression-free survival in HCC patients.
Advanced cellular immunotherapies, including T cell receptor (TCR) T cell therapy and chimeric antigen receptor (CAR) T cell therapy, are being explored for HCC treatment. These therapies offer a personalized approach by engineering T cells to target tumour antigens, showing potential in early-phase clinical trials. Oncolytic virotherapy and cancer vaccines are also in various stages of research and clinical development for HCC. Oncolytic virotherapy uses genetically modified viruses to selectively kill cancer cells while stimulating an anti-tumour immune response.
Despite advancements in immunotherapy for HCC, challenges remain, detailed the authors. These include identifying reliable biomarkers for predicting treatment response, managing immune-related adverse events, and overcoming resistance to immunotherapy. Future research should focus on optimizing combination therapies, developing novel immune-modulating agents, and understanding HCC’s immune evasion mechanisms.
Immunotherapy has transformed the HCC treatment landscape, offering new hope to patients. By targeting the TME and harnessing the immune system, immunotherapeutic approaches have shown significant potential. Ongoing research and clinical trials will be crucial in improving these treatments’ efficacy and safety, paving the way for the future of HCC therapy.
Victoria Antoniou, EMJ
Reference
Wei H et al. Treatment options for hepatocellular carcinoma using immunotherapy: present and future. J Clin Transl Hepatol. 2024;12(4):389-405.
