Rai Vikrant, Mukherjee Sandeep
Department of Translational Research, Western University of Health Sciences, Pomona, CA 91766, United States.
Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, United States.
World J Hepatol. 2022 Jan 27;14(1):140-157. doi: 10.4254/wjh.v14.i1.140.
Hepatocellular carcinoma, the most common primary liver cancer, in an immunogenic tumor with a poor prognosis because these tumors are diagnosed at late stages. Although, surgical resection, ablation, liver transplant, and locoregional therapies are available for early stages; however, there are yet no effective treatment for advanced and recurrent tumors. Immune checkpoint inhibitor therapy and adoptive cell transfer therapy has gained the popularity with some positive results because these therapies overcome anergy and systemic immune suppression. However, still there is a lack of an effective treatment and thus there is an unmet need of a novel treatment. At present, the focus of the research is on oncolytic viral therapy and combination therapy where therapies including radiotherapy, immune checkpoint therapy, adoptive cell transfer therapy, and vaccines are combined to get an additive or synergistic effect enhancing the immune response of the liver with a cytotoxic effect on tumor cells. This review discusses the recent key development, the basis of drug resistance, immune evasion, immune tolerance, the available therapies based on stage of the tumor, and the ongoing clinical trials on immune checkpoint inhibitor therapy, adoptive cell transfer therapy, oncolytic viral vaccine therapy, and combination therapy.
肝细胞癌是最常见的原发性肝癌，是一种免疫原性肿瘤，预后较差，因为这些肿瘤多在晚期才被诊断出来。虽然早期阶段可采用手术切除、消融、肝移植和局部区域治疗；然而，对于晚期和复发性肿瘤尚无有效的治疗方法。免疫检查点抑制剂疗法和过继性细胞转移疗法已受到欢迎并取得了一些积极成果，因为这些疗法克服了无反应性和全身免疫抑制。然而，仍然缺乏有效的治疗方法，因此迫切需要一种新的治疗方法。目前，研究重点在于溶瘤病毒疗法和联合疗法，即将放疗、免疫检查点疗法、过继性细胞转移疗法和疫苗等疗法联合起来，以获得增强肝脏免疫反应并对肿瘤细胞产生细胞毒性作用的相加或协同效应。本综述讨论了近期的关键进展、耐药性、免疫逃逸、免疫耐受的基础、基于肿瘤分期的可用疗法，以及正在进行的免疫检查点抑制剂疗法、过继性细胞转移疗法、溶瘤病毒疫苗疗法和联合疗法的临床试验。
