Immunotherapy for hepatocellular carcinoma
Hepatocellular carcinoma (HCC) is a rapidly progressive and highly lethal tumor worldwide, often associated with chronic liver disease. Although treatment options for HCC include curative resection, liver transplantation, transarterial chemoembolization, radioembolization, radiofrequency ablation, and chemotherapy, they have limited efficacy and may worsen the underlying liver condition, providing little benefit for the large number of patients with advanced liver cancer.
免疫療法和聯合療法的最新進展已經顯著改變了肝細胞癌（HCC）的治療前景。正在進行的臨床研究正在不斷取得進展，以進一步增強治療選擇。免疫療法已證明有可能提高特定 HCC 患者亞群的生存率並實現長期癌症控制，同時還可以減少不良反應的發生。探索免疫療法與現有療法相結合治療早期和中期 HCC 為更廣泛的患者帶來希望。繼續研究各種標記物，包括程序性細胞死亡-1/程序性細胞死亡配體1、腫瘤突變負荷、循環腫瘤DNA、微衛星穩定性、DNA錯配修復、嗜中性球/淋巴球比值、細胞激素和周邊免疫反應，旨在識別選擇和排序系統治療的最可靠指標，最終為 HCC 患者帶來最佳結果。
迄今為止，FDA 已批准七種免疫檢查點抑制劑(ICIs)，專門針對程序性細胞死亡蛋白1 (PD-1)、細胞毒性T 淋巴細胞抗原4 (CTLA-4) 或（ PD-L1) 蛋白。此外，還有其他有前景的免疫治療策略，例如嵌合抗原受體（CAR）T細胞療法、利用修飾免疫細胞的過繼性細胞治療、定制細胞因子和癌症疫苗，這些策略已接近準備就緒，並為肝細胞癌患者帶來了新的樂觀情緒（肝癌）。
Types of Immunotherapy
PD-1 inhibitors
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
Tislelizumab (Tevimbra)
PD-L1 inhibitors
Atezolizumab (Tecentriq)
Durvalumab (Imfinzi)
Cytotoxic T-lymphocyte antigen 4 (CTLA-4)
Ipilimumab (Yervoy)
Tremelimumab (Imjudo)
Reference: Mandlik DS, Mandlik SK, Choudhary HB. Immunotherapy for hepatocellular carcinoma: Current status and future perspectives. World J Gastroenterol. 2023 Feb 14;29(6):1054-1075. doi: 10.3748/wjg.v29.i6.1054. PMID: 36844141; PMCID: PMC9950866.
