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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2016; 22(1): 253-261
Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.253
Current status and perspectives of immune-based therapies for hepatocellular carcinoma
Maridi Aerts, Daphné Benteyn, Hans Van Vlierberghe, Kris Thielemans, Hendrik Reynaert
Maridi Aerts, Hendrik Reynaert, University hospital, UZ Brussel, Department of Gastroenterology and Hepatology, 1090 Brussels, Belgium
Daphné Benteyn, Kris Thielemans, Vrije Universiteit Brussel (VUB), Department of Immunology, 1090 Brussels, Belgium
Hans Van Vlierberghe, UZ Gent, Department of Gastroenterology and Hepatology, De Pinte laan, 9000 Ghent, Belgium
Author contributions: Aerts M, Benteyn D and Reynaert H analyzed the literature and wrote the manuscript; Van Vlierberghe H and Thielemans K critically revised the manuscript.; all authors approved the final version of the manuscript.
Supported by Grant from Kankerplan Action 29, Ministry of health, Belgium (to Aerts M); Van Vlierberghe H is senior researcher of the Flemish Fund for Research (FWO).
Conflict-of-interest statement: The authors have no conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hendrik Reynaert, MD, PhD, Professor, University hospital, UZ Brussel, Department of Gastroenterology and Hepatology, Laarbeeklaan 101, 1090 Brussels, Belgium. hendrik.reynaert@uzbrussel.be
Telephone: +32-2-4776811 Fax: +32-2-4776810
Received: June 8, 2015
Peer-review started: June 11, 2015
First decision: July 14, 2015
Revised: August 11, 2015
Accepted: October 26, 2015
Article in press: October 26, 2015
Published online: January 7, 2016
Abstract

Hepatocellular carcinoma (HCC) is a frequent cancer with a high mortality. For early stage cancer there are potentially curative treatments including local ablation, resection and liver transplantation. However, for more advanced stage disease, there is no optimal treatment available. Even in the case of a “curative” treatment, recurrence or development of a new cancer in the precancerous liver is common. Thus, there is an urgent need for novel and effective (adjuvant) therapies to treat HCC and to prevent recurrence after local treatment in patients with HCC. The unique immune response in the liver favors tolerance, which remains a genuine challenge for conventional immunotherapy in patients with HCC. However, even in this “immunotolerant” organ, spontaneous immune responses against tumor antigens have been detected, although they are insufficient to achieve significant tumor death. Local ablation therapy leads to immunogenic tumor cell death by inducing the release of massive amounts of antigens, which enhances spontaneous immune response. New immune therapies such as dendritic cell vaccination and immune checkpoint inhibition are under investigation. Immunotherapy for cancer has made huge progress in the last few years and clinical trials examining the use of immunotherapy to treat hepatocellular carcinoma have shown some success. In this review, we discuss the current status of and offer some perspectives on immunotherapy for hepatocellular carcinoma, which could change disease progression in the near future.

Keywords: Hepatocellular carcinoma, Immunotherapy, Dendritic cells, Dendritic cell vaccination, Therapy

Core tip: Hepatocellular carcinoma is a frequent cancer with a high mortality. For early stage cancer there are potentially curative treatments including local ablation, resection and liver transplantation. However, recurrence or development of a new tumor after treatment are not uncommon. Moreover, for more advanced stage disease, there is no optimal treatment available. Thus, there is an urgent need for novel and effective therapies for advanced stage hepatocellular carcinoma, and to prevent and to treat recurrence after local treatment of hepatocellular carcinoma.