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Semin Liver Dis 2021; 41(03): 263-276
DOI: 10.1055/s-0041-1730949
Review Article

Adjuvant versus Neoadjuvant Immunotherapy for Hepatocellular Carcinoma: Clinical and Immunologic Perspectives

Yung-Yeh Su
1   National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
2   Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
3   Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
,
Chia-Chen Li
4   Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
,
Yih-Jyh Lin
5   Division of General and Transplant Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
6   Liver Cancer Collaborative Oncology Group, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
,
Chiun Hsu
4   Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
7   Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
8   Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
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Abstract

Advancement in systemic therapy, particularly immune checkpoint inhibitor (ICI)-based combination regimens, has transformed the treatment landscape for patients with advanced hepatocellular carcinoma (HCC). The advancement in systemic therapy also provides new opportunities of reducing recurrence after curative therapy through adjuvant therapy or improving resectability through neoadjuvant therapy. Improved recurrence-free survival by adjuvant or neoadjuvant ICI-based therapy has been reported in other cancer types. In this article, developments of systemic therapy in adjuvant and neoadjuvant settings for HCC were reviewed. The design of adjuvant and neoadjuvant therapy using ICI-based regimens and potential challenges of trial conduct and result analysis was discussed. Results from these trials may extend the therapeutic benefit of ICI-based systemic therapy beyond the advanced-stage disease and lead to a new era of multidisciplinary management for HCC.

Keywords

antiangiogenic - biomarkers - cytotoxic T-lymphocyte-associated protein 4 (CTLA4) - program cell death-1 (PD-1) - tumor microenvironment

Supplementary Material



Publication History

Article published online:
15 June 2021

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