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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2023; 15(3): 405-424
Published online Mar 15, 2023. doi: 10.4251/wjgo.v15.i3.405
Immunotherapy for advanced or recurrent hepatocellular carcinoma
Ying-Zhe Luo, Hong Zhu
Ying-Zhe Luo, Department of Medical Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
Hong Zhu, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: All authors equally contributed to this paper regarding the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Supported by The Key Research Projects of Science and Technology of Sichuan Province, No. 2022YFS0189.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong Zhu, MD, PhD, Associate Professor, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. 441695131@qq.com
Received: September 18, 2022
Peer-review started: September 18, 2022
First decision: February 4, 2023
Revised: February 11, 2023
Accepted: February 27, 2023
Article in press: February 27, 2023
Published online: March 15, 2023
Processing time: 177 Days and 10.4 Hours
Abstract

Hepatocellular carcinoma (HCC) is associated with high morbidity and mortality, and is prone to intra- and extrahepatic metastasis due to the anatomical and functional characteristics of the liver. Due to the complexity and high relapse rate associated with radical surgery or radiofrequency ablation, immune checkpoint inhibitors (ICIs) are increasingly being used to treat HCC. Several immunotherapeutic agents, along with their combinations, have been clinically approved to treat advanced or recurrent HCC. This review discusses the leading ICIs in practice and those currently undergoing randomized phase 1–3 trials as monotherapy or combination therapy. Furthermore, we summarize the rapidly developing alternative strategies such as chimeric antigen receptor-engineered T cell therapy and tumor vaccines. Combination therapy is a promising potential treatment option. These immunotherapies are also summarized in this review, which provides insights into the advantages, limitations, and novel angles for future research in establishing viable and alternative therapies against HCC.

Keywords: Recurrent hepatocellular carcinoma; Immunotherapy; Immune checkpoint inhibitor; Chimeric antigen receptor-engineered T cell; Oncolytic virus; Tumor vaccine

Core Tip: The high recurrence rate of hepatocellular carcinoma (HCC) following radical treatment remains challenging; therefore, immune checkpoint inhibitors (ICIs) are increasingly being used to treat HCC. Herein, we discuss the ICIs in practice and those undergoing trials, and summarize the alternative strategies such as chimeric antigen receptor-engineered T cell therapy and tumor vaccines. Combination therapy is also a promising potential treatment option. We believe our study significantly contributes to the literature as it addresses the current state of immunotherapy against HCC and provides insights into the advantages and limitations, thereby facilitating future research.