Radiofrequency combined with immunomodulation for hepatocellular carcinoma: State of the art and innovations

World J Gastroenterol. 2020 May 7;26(17):2040-2048. doi: 10.3748/wjg.v26.i17.2040.

Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and has been considered a very immunogenic tumor. The treatment with radiofrequency ablation (RFA) has been established as the standard ablative therapy for early HCC, and is currently recognized as the main ablative tool for HCC tumors < 5 cm in size; however, progression and local recurrence remain the main disadvantages of this approach. To solve this clinical problem, recent efforts were concentrated on multimodal treatment, combining different strategies, including the combination of RFA and immunotherapy. This article reviewed the combination treatment of RFA with immunotherapy and found that this treatment strategy leads to an increased response of anti-tumor T cells, significantly reduces the risk of recurrence and improves survival rates compared to RFA alone. This review highlighted scientific evidence that supports the current recommendations for pre-clinical studies, and discuss the need for further research on this topic.

Keywords: Combined modality therapy; Hepatocellular carcinoma; Immunotherapy; Liver cancer; Radiofrequency ablation; State-of-the-art review.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / pharmacology
  • Antineoplastic Agents, Immunological / therapeutic use
  • CD8-Positive T-Lymphocytes / drug effects
  • CD8-Positive T-Lymphocytes / immunology
  • Carcinoma, Hepatocellular / immunology
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Combined Modality Therapy / methods
  • Disease Progression
  • Disease-Free Survival
  • Humans
  • Immunotherapy / methods*
  • Liver / immunology
  • Liver / pathology
  • Liver / surgery
  • Liver Neoplasms / immunology
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Lymphocytes, Tumor-Infiltrating / drug effects
  • Lymphocytes, Tumor-Infiltrating / immunology
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / prevention & control*
  • Radiofrequency Ablation / instrumentation
  • Radiofrequency Ablation / methods*
  • Randomized Controlled Trials as Topic
  • Review Literature as Topic
  • Survival Rate

Substances

  • Antineoplastic Agents, Immunological