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endolymphatic immunotherapy as a palliative strategy. The regression of the neoplastic mass, however, was not
evident at the imaging studies in neither group. The low dosage of IL-2 is responsible for two other important
advantages of this treatment: the virtual absence of major side effects and the low costs of the treatment.
In conclusion we firmly consider immunotherapy a good prospective for the treatment of HCC both for its
efficacy and for the low systemic toxicity in comparison to chemotherapy, which is often unacceptable in
patients with a such compromised liver level. On the other hand, the detection of molecular factors predictive
of response to anti-cancer agents such as Sorafenib® and the identification of mechanisms of resistance to anti-
[22]
cancer agents may probably represent another direction to improve the treatment of HCC.

DECLARATIONS
Authors’ contributions
Concept and design, data acquisition, data analysis, manuscript preparation: Lugaresi M, Katz Y, Bertelli R,
Ruhrman N, Puviani L, Cavallari G, De Vinci C, Pizza G, Nardo B
Critical revision and finalizing of the manuscript: Lugaresi M, Pizza G, Nardo B

Availability of data and materials
The data were strictly obtained from medical records according to the privacy policy and ethics code of our
institute.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
The local Institutional Review Board approved the use of the database for this retrospective review of the
case files.

Consent for publication
Consents from all of the patients were established prior to submission and all records were confidential.

Copyright
© The Author(s) 2018.

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