Why Adjuvant and Neoadjuvant Therapy Failed in HCC. Can the New Immunotherapy Be Expected to Be Better?

J Gastrointest Cancer. 2020 Dec;51(4):1193-1196. doi: 10.1007/s12029-020-00497-7.

Abstract

Introduction: HCC remains a challenging disease with its unique characteristics and aggressive behavior. Although there are some curative-intent treatments such as liver transplantation and surgical resection, they themselves did not cure the patients with relatively high recurrence rates. Several modalities including local ablation methods like TACE or TARE, systemic treatments such as chemotherapy, tyrosine kinase inhibitors or antiviral therapies are tested in adjuvant or neoadjuvant setting, but none of them offered a survival benefit (except antiviral therapy in HBV-related HCC).

Conclusion: After a decade of plateau in drug development, ICPIs came into podium with their different mechanism of action consistent with immunogenic nature of the disease and with high expectations, and ongoing trials will show if these agents can satisfy unmet demand in this area.

Keywords: Adjuvant; Immunotherapy; Neoadjuvant.

Publication types

  • Review

MeSH terms

  • Ablation Techniques / methods
  • Carcinoma, Hepatocellular / immunology
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / methods
  • Chemotherapy, Adjuvant / methods
  • Disease-Free Survival
  • Drug Development
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immunotherapy / methods
  • Liver Neoplasms / immunology
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Neoadjuvant Therapy / methods*
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Protein Kinase Inhibitors / therapeutic use
  • Radiotherapy, Adjuvant / methods
  • Time Factors
  • Treatment Failure

Substances

  • Immune Checkpoint Inhibitors
  • Protein Kinase Inhibitors