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da Fonseca et al. Hepatoma Res 2019;5:37 Hepatoma Research
DOI: 10.20517/2394-5079.2019.012

Review Open Access

Updates in immunotherapy for hepatocellular
carcinoma

Leonardo G. da Fonseca , Flair José Carrilho 2
1
1 Medical Oncology, São Paulo Clínicas Liver Cancer Group, Hospital das Clínicas Complex, Instituto do Cancer do Estado de São
Paulo, University of São Paulo School of Medicine, São Paulo, SP 05403-000, Brazil.
2 Department of Gastroenterology, São Paulo Clínicas Liver Cancer Group, Hospital das Clínicas Complex, Instituto do Cancer do
Estado de São Paulo, University of São Paulo School of Medicine, São Paulo, SP 05403-000, Brazil.
Correspondence to: Dr. Leonardo G. da Fonseca, Medical Oncology, São Paulo Clínicas Liver Cancer Group, Hospital das Clínicas
Complex, Instituto do Cancer do Estado de São Paulo, University of São Paulo School of Medicine, Av Dr. Eneás Carvalho de
Aguiar, 255 ICHC - 9th floor, room 9159, São Paulo, SP 05403-000, Brazil. E-mail: l.fonseca@fm.usp.br

How to cite this article: da Fonseca LG, Carrilho FJ. Updates in immunotherapy for hepatocellular carcinoma. Hepatoma Res
2019;5:37. http://dx.doi.org/10.20517/2394-5079.2019.012

Received: 9 Sep 2019 First Decision: 29 Sep 2019 Revised: 7 Oct 2019 Accepted: 8 Oct 2019 Published: 13 Oct 2019

Science Editor: Dalbir Sandhu Copy Editor: Cai-Hong Wang Production Editor: Jing Yu
Received: First Decision: Revised: Accepted: Published:

Science Editor: Copy Editor: Production Editor: Jing Yu Abstract
Hepatocellular carcinoma (HCC) carries an unfavorable prognosis and novel therapeutic strategies are needed. Until
now, only few systemic agents have improved survival in patients with advanced stage disease. Immunotherapy
changed the landscape in several tumor types by producing unprecedented clinical outcomes with a favorable safety
profile. Liver presents a particular immune-suppressive microenvironment and HCC develops in a background
of chronic inflammation in the vast majority of cases. In this regard, immunotherapy may be a suitable strategy.
Preliminary research focused on therapies involving immune cells and anti-tumor immune response for HCC has
shown encouraging preliminary results. Immune checkpoint inhibitors, such the anti-PD-1/PD-L1 monoclonal
antibodies, have provided durable responses in patients with advanced stage disease, although the pioneers phase
III trials did not confirm survival superiority over the available agents. Cancer vaccines, adoptive cellular therapies
and combinations of local modalities with immunotherapy are promising approaches under active research.

Keywords: Hepatocellular carcinoma, immunotherapy, immunosuppression, prognosis, immunology, antibody,
vaccine

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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