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Armstrong et al. Hepatoma Res 2021;7:18 Hepatoma Research
DOI: 10.20517/2394-5079.2020.118

Review Open Access

Immunotherapy and immunotherapy biomarkers for
hepatocellular carcinoma

Samantha Armstrong, Petra Prins, Aiwu Ruth He

Hematology and Oncology, MedStar Georgetown University Hospital, Washington, DC 20007, USA.
Correspondence to: Aiwu Ruth He, Hematology and Oncology, MedStar Georgetown University Hospital, 3800 Reservoir Rd
NW, Washington, DC 20007, USA. E-mail: aiwu.r.he@gunet.georgetown.edu

How to cite this article: Armstrong S, Prins P, He AR. Immunotherapy and immunotherapy biomarkers for hepatocellular
carcinoma. Hepatoma Res 2021;7:18. http://dx.doi.org/10.20517/2394-5079.2020.118

Received: 5 Oct 2020 First Decision: 24 Nov 2020 Revised: 10 Dec 2020 Accepted: 15 Dec 2020 Published: 9 Mar 2021

Academic Editor: Sandi Alexander Kwee Copy Editor: Miao Zhang Production Editor: Jing Yu

Abstract
Hepatocellular carcinoma (HCC) is increasing in prevalence and has the potential to be a highly lethal malignancy.
Received: First Decision: Revised: Accepted: Published: Patients with early-stage HCC have potentially curative therapeutic options, but treatments for more advanced
HCC were limited until recently. Historically, tyrosine kinase inhibitors have been used in both the first- and
Science Editor: Copy Editor: Production Editor: Jing Yu second-line treatment of patients with advanced HCC; however, given HCC’s highly immune-responsive origins,
immunotherapy is proving to be a promising systemic therapy in the frontline as well as later lines of treatment.
Notably, recent studies of the novel antibody therapy combination atezolizumab (anti-PD-L1) and bevacizumab
demonstrated unprecedented, practice-changing efficacy in the advanced HCC setting and led to its Food and
Drug Administration approval. Although such landmark studies offer new treatment options for patients with
HCC, the role of potential biomarkers to monitor immunotherapy response is largely unknown and undergoing
exploration.

Keywords: Hepatocellular carcinoma, immunotherapy, checkpoint inhibitor, biomarkers

INTRODUCTION
Hepatocellular carcinoma (HCC) is the fifth leading cancer globally and the second leading cause of
[1]
cancer-related death . HCC in the United States is prevalent; it is estimated that there will be 42,810 new
[2]
diagnoses and 30,160 cancer-related deaths during 2020 . Men are slightly more at risk for developing
HCC versus women (3:1 male to female ratio). HCC often arises as a result of underlying liver disease such

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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