Radiation therapy in the era of immune treatment for hepatocellular carcinoma

Lingjuan Chen; Ruiguang Zhang; Zhenyu Lin; Qiaoyun Tan; Zhiyong Huang; Binyong Liang

doi:10.3389/fimmu.2023.1100079

Radiation therapy in the era of immune treatment for hepatocellular carcinoma

Front Immunol. 2023 Jan 20:14:1100079. doi: 10.3389/fimmu.2023.1100079. eCollection 2023.

Authors

Lingjuan Chen¹, Ruiguang Zhang¹, Zhenyu Lin¹, Qiaoyun Tan¹, Zhiyong Huang², Binyong Liang²

Affiliations

¹ Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Hepatic Surgery Center, Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment in recent years and provide new opportunities to treat hepatocellular carcinoma (HCC). To date, several ICIs have been approved by the FDA for advanced HCC in first-line or second-line therapy. Downstaging conversion therapy for potentially resectable HCC to provide opportunities for surgical intervention is challenging. ICIs have become a hot spot in this field due to their high response rate. However, HCC has various etiologies and can evade the immune system through multiple mechanisms, which limit the efficacy of ICI monotherapy and demand novel combination strategies. Radiation therapy (RT) is also a candidate for conversion therapy in HCC and is currently gaining increasing attention as a good combination partner with ICIs due to its ability to modulate the tumor microenvironment. In this review, we illustrate the current indications for ICIs and RT in HCC, the rationale for their synergistic combination, and the current clinical trials in combination therapy. We also speculate on predictive biomarkers and novel future strategies to further enhance the efficacy of this combination. This review aims to provide references for future research on radiation and immunotherapy to arrive at a promising new era of HCC treatment.

Keywords: combination therapy; hepatocellula carcinoma; immune checkpoint inhibitor (ICI); radiation therapy; tumor microenevironment.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Hepatocellular* / radiotherapy
Combined Modality Therapy
Dermatitis*
Humans
Immunotherapy
Liver Neoplasms* / radiotherapy
Tumor Microenvironment

Grants and funding

This work was supported by the Bethune-Cancer Radiotherapy Translational Medicine Research Fund of China (Grant No. flzh202117) and the Beijing Kechuang Medical Development Foundation Fund of China (Grant No. KC2021-JX-0186-31).