Tagliamonte Maria, Petrizzo Annacarmen, Mauriello Angela, Tornesello Maria Lina, Buonaguro Franco M, Buonaguro Luigi
Lab of Cancer Immunoregulation Unit.
Lab of Molecular Biology & Viral Oncology, Dept Experimental Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione Pascale" - IRCCS, Naples, Italy.
Oncoimmunology. 2018 Jul 23;7(10):e1488564. doi: 10.1080/2162402X.2018.1488564. eCollection 2018.
Hepatocellular carcinoma (HCC) is the most common liver malignancy with a poor prognosis and an overall 5-year survival rate of approximately 5-6%. This is due because standard of care treatment options are limited and none of them shows a sufficient efficacy. HCC is an "inflammation-induced cancer" and preliminary preclinical and clinical data suggest that immunotherapeutic approaches may be a good alternative candidate for the treatment of HCC patients improving the dismal prognosis associated with this cancer. However, recent findings strongly suggest that an optimal immunotherapy in HCC requires the combination of an immune activator with immune modulators, aiming at compensating the strong liver immune suppressive microenvironment. One of the most promising strategy could be represented by the combination of a cancer vaccine with immunomodulatory drugs, such as chemotherapy and checkpoint inhibitors. Very limited examples of such combinatorial strategies have been evaluated in HCC to date, because HCC easily develops resistance to standard chemotherapy, which is also poorly tolerated by patients with liver cirrhosis. The present review describes the most update knowledge in this field.
肝细胞癌（HCC）是最常见的肝脏恶性肿瘤，预后较差，总体5年生存率约为5%-6%。这是因为标准治疗方案有限，且没有一种方案显示出足够的疗效。HCC是一种“炎症诱导的癌症”，初步的临床前和临床数据表明，免疫治疗方法可能是治疗HCC患者的一个很好的替代选择，可改善与这种癌症相关的不良预后。然而，最近的研究结果强烈表明，HCC的最佳免疫治疗需要将免疫激活剂与免疫调节剂联合使用，旨在补偿肝脏强大的免疫抑制微环境。最有前景的策略之一可能是癌症疫苗与免疫调节药物（如化疗药物和检查点抑制剂）联合使用。迄今为止，在HCC中评估的此类联合策略的例子非常有限，因为HCC很容易对标准化疗产生耐药性，而肝硬化患者对化疗的耐受性也很差。本综述描述了该领域的最新知识。
