Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jun 24, 2022; 13(6): 448-472
Published online Jun 24, 2022. doi: 10.5306/wjco.v13.i6.448
Immunotherapy for advanced hepatocellular carcinoma: From clinical trials to real-world data and future advances
Kathrine S Rallis, Dimitrios Makrakis, Ioannis A Ziogas, Georgios Tsoulfas
Kathrine S Rallis, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, United Kingdom
Kathrine S Rallis, Dimitrios Makrakis, Ioannis A Ziogas, Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece
Dimitrios Makrakis, Division of Oncology, University of Washington School of Medicine, Seattle, WA 98195, United States
Ioannis A Ziogas, Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee 37232, United States
Georgios Tsoulfas, Department of Transplantation Surgery, Aristotle University School of Medicine, Thessaloniki 54622, Greece
Author contributions: Rallis KS and Makrakis D contributed equally to the writing, reviewing, and designing of the manuscript and are equal joint first authors; Ziogas IA and Tsoulfas G lead the initial conceptualization, designing, reviewing, and supervision of the work in this manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
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: Georgios Tsoulfas, FACS, FICS, MD, PhD, Professor, Department of Transplantation Surgery, Aristotle University School of Medicine, 66 Tsimiski Street, Thessaloniki 54622, Greece. tsoulfasg@gmail.com
Received: January 31, 2022
Peer-review started: January 31, 2022
First decision: April 13, 2022
Revised: April 27, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 24, 2022
Processing time: 141 Days and 12.9 Hours
Core Tip

Core Tip: In the last five years, immune checkpoint inhibitors (ICIs) have entered the treatment landscape of hepatocellular carcinoma (HCC) in the 1st and 2nd line setting. However, due to restrictions in clinical trial inclusion and exclusion criteria, there remains a need for further real-world data on the efficacy, toxicity, and cost-effectiveness of ICIs in a broader cohort of HCC patients. New trials are underway investigating further ICI regimens, including combination therapy strategies, while novel immunotherapies are also being brought to the fore. This review discusses key clinical trials, real-world data, and future advances of immunotherapy for HCC, with a focus on ICIs.