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Lu et al. Hepatoma Res 2018;4:21 I http://dx.doi.org/10.20517/2394-5079.2018.44 Page 7 of 10

Figure 1. Gene-based SNPs associated with HCC in the antigen processing and presentation pathway. The genes and their relationships
obtained from KEGG’s antigen processing and presentation pathway. Purple boxes with white letters indicate genes SNP variations
associated with HCC from the PoDA stepdown analysis. Removal of these loci reduced the overall threshold of significance below that
observed for the entire pathway. Genes in open boxes (with orange letters) indicate gens which could be removed without altering
significance of the pathway’s association. HCC: hepatocellular carcinoma

[33]
Unfortunately only a minority of individuals respond to the treatments . It is unknown what mediates
[34]
response. Indicators of response include DNA mismatch repair capabilities and tumor mutational
[35]
burden . But these have poor predictive capabilities.
For checkpoint therapy to work, an intact immune response is required. As implied from the indicators of
response, the immune system must have the capacity to recognize tumor antigens as foreign. This recognition
is mediated through antigen processing and presentation. Inherited variability may indicate individuals in
which this capacity is compromised. Moreover, variation in these processes may indicate individual response
to immune directed therapeutic interventions.