Immunotherapy for hepatocellular carcinoma: Current status and future perspectives

Core Tip

Core Tip: Hepatocellular carcinoma (HCC) is a multifaceted illness with multiple faces. It avoids early discovery, which provides the best chance of cure by resection/transplant, and systemic treatments are only of marginal efficacy at best, despite recent therapeutic advances. Current advances in immunotherapy and its combinations have altered the HCC treatment landscape, and clinical studies are continuing to pave the path forward. Immunotherapy increases survival rates and provides long-term cancer control in subsets of HCC patients while also minimizing side effects. Further research into immunotherapy in combination with current treatments for HCC in the early and intermediate stages may assist a greater spectrum of patients. Continued research into programmed cell death-1/ programmed cell death ligand 1, TMB, ctDNA, microsatellite stability, DNA mismatch repair, neutrophil/lymphocyte ratio, cytokines, and cellular peripheral immune response will hopefully identify the most reliable marker for selecting and sequencing systemic treatments to achieve the best outcome in HCC patients. Despite such significant treatment advances in HCC, numerous hurdles remain. The scientific community must figure out how to appropriately sequence these medicines for the best potential response, how to control toxicities, and how to develop indicators to monitor for response and relapse.