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Page 8 of 10 Lu et al. Hepatoma Res 2018;4:21 I http://dx.doi.org/10.20517/2394-5079.2018.44

In conclusion, the results of the germline variation studies suggest that immune mediating processes are
polymorphic in the population and systematically different in HCC. Individuals with HCC have significantly
lower activity for these processes and HCC shows alterations in the “logic” of the processing and presentation
pathways. As such, it may be possible to predict response to checkpoint therapy through the evaluation of the
inherited genetic state of “antigen processing and presentation”. Understanding these differences may provide
opportunities designing new immune checkpoint modulators and provide a rational basis for combinatorial
therapy.

DECLARATIONS
Acknowledgments
The Korean HCC case-control study was collected by Dr. Myung Lyu (NCI/NIH/DHSS) and Dr. Young-Hwa
Chung (Asan Medical Center, Seoul, South Korea).

Authors’ contributions
Data analysis: Lu YK, Brill JM, Aghili A
Design of the work, data analysis, manuscript drafting and revising, and final approval of the version to be
published: Buetow KH

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Buetow KH is an advisor for the Bristol Myers Squibb IO-ICON project.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2018.

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