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Feun et al. Hepatoma Res 2017;3:43-51 Hepatoma Research
DOI: 10.20517/2394-5079.2016.45
www.hrjournal.net
Topic: Novel Approaches for HCC Open Access

Immunotherapy for hepatocellular

carcinoma: the force awakens in HCC?

Lynn G. Feun, Ying-Ying Li, Medhi Wangpaichitr, Chun-Jing Wu, Niramol Savaraj

Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA.

Correspondence to: Prof. Lynn G. Feun, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA.
E-mail: lfeun@med.miami.edu
How to cite this article: Feun LG, Li YY, Wangpaichitr M, Wu CJ, Savaraj N. Immunotherapy for hepatocellular carcinoma: the force awakens in
HCC? Hepatoma Res 2017;3:43-51.

Dr. Lynn G. Feun is a Professor of Medicine in Sylvester Comprehensive Cancer Center, University of Miami. He
graduated from the Wayne State University School of Medicine in 1974. His clinical and research interests include
liver cancer, melanoma, skin cancers, and neuro oncology (primary brain and spine tumors). His specialty is
hematology/oncology - internal medicine. Dr. Feun is in the American Board of Internal Medicine and American Board
of Internal Med-Medical Oncology. He is also affiliated with Jackson Memorial Hospital and the University of Miami
Hospital.

ABSTRACT

Article history: Systemic therapy for hepatocellular carcinoma (HCC) has been disappointing. The only
Received: 18-11-2016 drug approved by Food and Drug Administration recently has been sorafenib. Sorafenib has
Accepted: 07-01-2017 modest benefits with a low response rate and an improvement in time to progression of only
Published: 22-03-2017 2-3 months. Multiple randomized trials, which compare the new agent to sorafenib as either
first line or second line therapy, have been negative, showing no improved clinical benefit.
Key words: Recently, in a large phase III randomized trial, regorafenib has shown superiority to placebo
Immunotherapy, as a second line treatment for HCC. However, this drug has multiple side effects and is not
hepatocellular carcinoma, well tolerated by many patients. The clinical benefit is also modest. Clearly, new approaches
sorafenib, to treat advanced HCC are still needed. There is data showing that HCC is immunogenic and
new approaches the immune system can be stimulated to attack these cancer cells. This article will briefly
review immunotherapy as a promising treatment for HCC.

INTRODUCTION typically develops in a setting of long standing liver
cirrhosis. On the other hand, HCC may develop
There is a strong rationale to evaluate immunotherapy from HBV even in the absence of liver cirrhosis.
in this disease. Hepatocellular carcinoma (HCC) is Increasingly, HCC appears to be developing from
typically an inflammation-associated cancer and can nonalcoholic steatohepatitis (NASH) with obesity
be immunogenic. Both hepatitis B virus (HBV) and being a risk factor. Studies in mice have shown that
hepatitis C virus (HCV) are known to be risk factors dietary factors and genetic obesity can promote liver
for the development of HCC. The HCC from HCV inflammation and tumorigenesis. This appears to be
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