Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hepatic Surgery Center, Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Immunol. 2023 Jan 20;14:1100079. doi: 10.3389/fimmu.2023.1100079. eCollection 2023.
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment in recent years and provide new opportunities to treat hepatocellular carcinoma (HCC). To date, several ICIs have been approved by the FDA for advanced HCC in first-line or second-line therapy. Downstaging conversion therapy for potentially resectable HCC to provide opportunities for surgical intervention is challenging. ICIs have become a hot spot in this field due to their high response rate. However, HCC has various etiologies and can evade the immune system through multiple mechanisms, which limit the efficacy of ICI monotherapy and demand novel combination strategies. Radiation therapy (RT) is also a candidate for conversion therapy in HCC and is currently gaining increasing attention as a good combination partner with ICIs due to its ability to modulate the tumor microenvironment. In this review, we illustrate the current indications for ICIs and RT in HCC, the rationale for their synergistic combination, and the current clinical trials in combination therapy. We also speculate on predictive biomarkers and novel future strategies to further enhance the efficacy of this combination. This review aims to provide references for future research on radiation and immunotherapy to arrive at a promising new era of HCC treatment.
免疫检查点抑制剂 (ICIs) 近年来改变了癌症治疗方式，为治疗肝细胞癌 (HCC) 提供了新的机会。迄今为止，已有多种 ICIs 被 FDA 批准用于 HCC 的一线或二线治疗。通过降期转化治疗将潜在可切除 HCC 转化为有手术机会的 HCC 是具有挑战性的。由于其高反应率，ICI 成为该领域的热点。然而，HCC 有多种病因，并可通过多种机制逃避免疫系统，这限制了 ICI 单药治疗的疗效，并需要新的联合策略。放疗 (RT) 也是 HCC 转化治疗的候选方法，由于其能够调节肿瘤微环境，因此作为 ICI 的良好联合伙伴，目前越来越受到关注。在这篇综述中，我们说明了 HCC 中 ICI 和 RT 的当前适应证、它们协同联合的原理以及联合治疗的当前临床试验。我们还推测了预测生物标志物和新的未来策略，以进一步提高这种联合的疗效。本综述旨在为未来的放射免疫治疗研究提供参考，以迎来 HCC 治疗的新时代。
