Preoperative Immunotherapy in Hepatocellular Carcinoma: Current State of the Art

Alena Laschtowitz, Christoph Roderburg, Frank Tacke, Raphael Mohr

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Hepatocellular carcinoma (HCC) is a malignancy that requires multidisciplinary evaluation to develop individualized and tailored treatment concepts. While liver resection and transplantation represent the mainstay of curative treatment in patients with early-stage HCC, disease recurrence remains an important burden. Immune checkpoint inhibitors (ICI) have become standard of care in the palliative setting, achieving promising response rates with overall good tolerability. Accordingly, ICIs are being evaluated in (neo)adjuvant concepts in order to improve survival. Nevertheless, neoadjuvant therapies are not recommended by current guidelines as they have not been proven to improve the outcome in large Phase III trials yet. Especially in the context of liver transplantation (LT), perioperative ICI usage is in need of a particularly critical risk–benefit assessment, as the immunotherapy may significantly increase the risk of rejection. In this review, we summarize available data on ICI-based perioperative treatment strategies in HCC. We discuss current drawbacks and challenges of this treatment concept and specifically highlight the risk of allograft rejection when ICI are given in patients (subsequently) considered for liver transplantation.

Original languageEnglish
Pages (from-to)181-191
Number of pages11
JournalJournal of Hepatocellular Carcinoma
Volume10
DOIs
StatePublished - 1 Feb 2023
Externally publishedYes

Keywords

  • checkpoint inhibitor
  • hepatocellular carcinoma
  • immune oncology
  • neoadjuvant

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