Immunotherapy and Transarterial therapy of HCC: What the interventional radiologist needs to know about the changing landscape of HCC treatment?

Abstract

Hepatocellular carcinoma (HCC) is the fourth most common cancer worldwide and its incidence is increasing in Australia. Transarterial therapy, predominantly transarterial chemoembolization (TACE) but increasingly transarterial radioembolization (TARE), plays an important role in patients with intermediate-stage disease and preserved liver function. However, despite advances in TACE, TARE and adjunctive procedures, overall survival has only modestly increased over the last 20 years. Immunotherapy has emerged as a newer cancer treatment and uses antibodies directed at checkpoint inhibitors to upregulate T-cell mediated tumour-specific death. These drugs have been shown to increase survival in patients with HCC and have changed the landscape for advanced disease. Trials are now ongoing combining transarterial therapy and immunotherapy. This manuscript introduces these trials and interventional radiologists should be aware of the changing landscape so that they can partner with immunotherapy and remain relevant in the HCC multidisciplinary group as immunotherapy use increases.

Identification of a cuproptosis and copper metabolism gene–related lncRNAs prognostic signature associated with clinical and immunological characteristics of hepatocellular carcinoma

“…Immunotherapy, an emerging treatment modality that selectively kills tumor cells via the immune system, has emerged as a key player in the treatment of HCC in recent years. Nivolumab, pembrolizumab, and camrelizumab, for example, improve patients' overall survival (7)(8)(9). Nonetheless, HCC recurrence and metastasis rates remain high, and the prognosis remains poor.…”

Recent Progress in Advanced Hydrogel‐Based Embolic Agents: From Rational Design Strategies to Improved Endovascular Embolization

“…[222][223][224] However, the systemic administration of immune checkpoint inhibitors (e.g., anti-PD-L1, anti-PD-1) causes substantial systemic adverse effects with compromised therapeutic effects, which undoubtedly limit their wide application in the clinic. [225,226] Hydrogels are favorable to be used as a drug depot to encapsulate immunotherapy drug and facilitate the local immunomodulation of the tumor microenvironment. Besides, the therapeutic hydrogels could combine with distinct therapies (e.g., chemotherapy, radiotherapy, magnetic thermal therapy) to induce amplified tumor immunogenicity, which could greatly enhance the inhibition of tumor growth and reduce the risk of tumor recurrence and metastasis.…”

A Anoikis-Related Risk Model: Predicts Prognosis and Immunotherapy Response for Hepatocellular Carcinoma

“…The liver has a unique immune microenvironment where exists immune cells such as Myeloid-derived suppressor cell (MDSC), dendritic cells (DC), tumor associated macrophages (TAMs), natural killer cells (NK), cytotoxic lymphocytes (CTL), and regulatory T cells (Treg). The non-immune cells in liver include cancer related broblasts (CAFs), hepatic stellate cells (HSCs), and liver endothelial cells [32]. Both the immune and non-immune cells participate in immune tolerance and response of HCC, and affect its development and prognosis.…”