Immune microenvironment in hepatocellular carcinoma: current concepts and the role of blockade of immune checkpoints

Abstract

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. The specificity of the immune microenvironment of an organ limits the possibilities of traditional therapeutic and surgical approaches to treatment, therefore one of the most important tasks of modern medicine is the search for new therapeutic targets targeting the tumor microenvironment. The introduction of checkpoint inhibitors into clinical practice expands immunotherapeutic options in the fight against liver cancer. The purpose of our review is to summarize the available data on the liver immune microenvironment in hepatocellular carcinoma and to present advances in cancer immunotherapy using immune checkpoint blockade. Material and methods. An analysis of the main foreign and domestic sources was carried out using the PubMed/Medline, ClinicalTrials.gov databases over the past 5 years. Results. In terms of morbidity and mortality, hepatocellular carcinoma is included in the list of the most common malignant neoplasms in the world and the forecasts for the coming decades are disappointing. Modern approaches to immunotherapy, taking into account the tumor microenvironment, are associated with better survival rates and safety profiles than standard therapy. Conclusion. The effectiveness of checkpoint inhibitors as monotherapy and combination strategies offers hope for improving the prognosis and quality of life of patients with unresectable HCC.