Immune Efficacy of Immunotherapeutic Agents for Hepatocellular Carcinoma

tibbionko-17-1-kapak

Murat BARDAKÇIa , Mehmet Ali Nahit ŞENDURa,b
aAnkara Bilkent City Hospital, Clinic of Medical Oncology, Ankara, Türkiye
bAnkara Yıldırım Beyazıt University Faculty of Medicine, Department of Medical Oncology, Ankara, Türkiye

Bardakçı M, Şendur MAN. Immune efficacy of immunotherapeutic agents for hepatocellular carcinoma. In: Şendur MAN, ed. Current Immunotherapy Landscape for Solid Tumors. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.82-6.

ABSTRACT
Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide and up to 90% of HCC cases are caused by underlying cirrhosis. Clinically approved tyrosine kinase inhibitors (TKIs) for the treatment of patients with HCC who are unresectable and ineligible for curative therapies have shown limited improvement in survival rates. Immune checkpoint inhibitors (ICIs) are landmark drugs used in the treatment of many solid tumors, including HCC. While single-agent immunotherapy drugs have shown limited efficacy in the treatment of HCC, the combination of anti-programmed cell death ligand-1 (PD-L1) atezolizumab and anti-vascular endothelial growth factor (VEGF) bevacizumab showed a significant improvement in survival rates compared with sorafenib as first-line treatment. Furthermore, durvalumab-tremelimumab was shown to be superior to sorafenib, making this treatment a new first-line option. These results further encourage the preclinical and clinical development of immunotherapeutic treatment. In contrast, inconsistent results have been obtained with combinations of ICIs and tyrosine kinase inhibitors, with only one phase-III trial showing OS benefit. In conclusion, the combination of ICIs with other therapies such as anti-VEGF, anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4), and TKIs has been shown to improve the overall response rate and survival of monoclonal antibodies.

Keywords: Immune checkpoint inhibitors; hepatocellular carcinoma; sorafenib; atezolizumab; bevacizumab

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