Immunotherapy for hepatocellular carcinoma recurrence after liver transplantation, can we harness the power of immune checkpoint inhibitors?

Front Immunol. 2023 Feb 16:14:1092401. doi: 10.3389/fimmu.2023.1092401. eCollection 2023.

Abstract

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death globally and liver transplantation (LT) can serve as the best curative treatment option. However, HCC recurrence after LT remains the major obstacle to the long-term survival of recipients. Recently, immune checkpoint inhibitors (ICIs) have revolutionized the treatment of many cancers and provided a new treatment strategy for post-LT HCC recurrence. Evidence has been accumulated with the real-world application of ICIs in patients with post-LT HCC recurrence. Notably, the use of these agents as immunity boosters in recipients treated with immunosuppressors is still controversial. In this review, we summarized the immunotherapy for post-LT HCC recurrence and conducted an efficacy and safety evaluation based on the current experience of ICIs for post-LT HCC recurrence. In addition, we further discussed the potential mechanism of ICIs and immunosuppressive agents in regulating the balance between immune immunosuppression and lasting anti-tumor immunity.

Keywords: hepatocellular carcinoma; immune checkpoint inhibitor; immunosuppression; liver transplantation; transplant tolerance.

Publication types

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

MeSH terms

  • Carcinoma, Hepatocellular*
  • Humans
  • Immune Checkpoint Inhibitors
  • Immunotherapy
  • Liver Neoplasms*
  • Liver Transplantation*

Substances

  • Immune Checkpoint Inhibitors

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (No. 82171757 and 82011530442), Natural Science Foundation of Zhejiang Province (No. LZ22H030004).