Immunotherapy for Hepatocellular Carcinoma: Current Status and Future Perspectives

For most patients with advanced hepatocellular carcinoma (HCC), surgery with curative intent or a locally ablative technique, such as percutaneous ethanol injection or radiofre‐ quency ablation, are no longer available [1]. Patients can now be treated using transarte‐ rial chemoembolization (TACE) or systemic chemotherapy. Several chemotherapeutic drugs have been developed and tested. The anti-tumor effect of these treatments is limit‐ ed and adverse reactions are not tolerated in advanced HCC patients with liver cirrhosis, which affects drug metabolism and toxicity [1-3]. Thus far, sorafenib, a multi-targeted ty‐ rosine kinase inhibitor, is the only drug that has been shown to significantly prolong sur‐ vival (by nearly 3 months) in patients with advanced HCC [4, 5]. However, the incidence of adverse drug reactions is high, particularly in elderly patients, and no second-line treatment has been established for patients who have failed sorafenib treatment [6]. Thus, new treatment modalities are urgently required to prolong survival in patients with advanced HCC while minimizing the risk of adverse reactions.