Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy.
Int J Mol Sci. 2023 May 11;24(10):8598. doi: 10.3390/ijms24108598.
Immunotherapy has remarkably revolutionized the management of advanced HCC and prompted clinical trials, with therapeutic agents being used to selectively target immune cells rather than cancer cells. Currently, there is great interest in the possibility of combining locoregional treatments with immunotherapy for HCC, as this combination is emerging as an effective and synergistic tool for enhancing immunity. On the one hand, immunotherapy could amplify and prolong the antitumoral immune response of locoregional treatments, improving patients' outcomes and reducing recurrence rates. On the other hand, locoregional therapies have been shown to positively alter the tumor immune microenvironment and could therefore enhance the efficacy of immunotherapy. Despite the encouraging results, many unanswered questions still remain, including which immunotherapy and locoregional treatment can guarantee the best survival and clinical outcomes; the most effective timing and sequence to obtain the most effective therapeutic response; and which biological and/or genetic biomarkers can be used to identify patients likely to benefit from this combined approach. Based on the current reported evidence and ongoing trials, the present review summarizes the current application of immunotherapy in combination with locoregional therapies for the treatment of HCC, and provides a critical evaluation of the current status and future directions.
免疫疗法极大地改变了晚期 HCC 的治疗管理方式，并促使开展了临床试验，治疗药物被用于选择性地靶向免疫细胞而不是癌细胞。目前，人们对 HCC 中联合局部治疗和免疫疗法的可能性非常感兴趣，因为这种联合治疗正在成为增强免疫的有效协同工具。一方面，免疫疗法可以放大和延长局部治疗的抗肿瘤免疫反应，改善患者的预后并降低复发率。另一方面，局部治疗已被证明可以积极改变肿瘤免疫微环境，从而增强免疫疗法的疗效。尽管结果令人鼓舞，但仍有许多悬而未决的问题，包括哪种免疫疗法和局部治疗可以保证最佳的生存和临床结果；获得最有效治疗反应的最有效时机和顺序；以及哪些生物和/或遗传标志物可用于识别可能受益于这种联合治疗方法的患者。基于目前报道的证据和正在进行的试验，本综述总结了免疫疗法联合局部治疗 HCC 的最新应用，并对现状和未来方向进行了批判性评估。
