Immunotherapy in liver metastases: Challenges, emerging evidence, and future directions

doi:10.5306/wjco.v17.i3.116093

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World Journal of Clinical Oncology

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2218-4333

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Oncol. Mar 24, 2026; 17(3): 116093
Published online Mar 24, 2026. doi: 10.5306/wjco.v17.i3.116093

Table 4 Summary of clinical evidence for ablative therapies in liver metastases across tumor types

Technique	Typical local control rate	Any OS benefit in RCTs	Comments
RFA[169]	80%-95% (CRLM)	Yes (CLOCC: 8-year OS 35.9% vs 8.9%, HR = 0.58, P = 0.01)	Effective for small, oligometastatic CRLM; potentially curative; added to systemic therapy in unresectable CRLM
MWA[174,175]	≥ 85% (various primaries)	Not reported	May outperform RFA for perivascular tumors due to reduced heat-sink effects
Cryoablation[169]	≥ 85% (various primaries)	Not reported	High local control for breast, lung, neuroendocrine metastases; symptom palliation
SBRT[169]	83%-94% (small lesions < 3 cm)	Not reported	Minimal grade ≥ 3 toxicity (< 10%)
Ablation (general)[171,172]	80%-95% (CRLM)	Yes (collision: HR = 1.05, P = 0.83, non-inferior to surgery)	Non-inferior to surgery for OS and local control in CRLM; promising with ICI
Ablation + ICI[177,178]	Not specified	Yes (IMbrave050: Improved RFS/OS vs ICI alone)	Improved RFS/OS in HCC; unconfirmed long-term OS benefit; EORTC-1560 ILOC showed no response in untreated metastases

ICI: Immune checkpoint inhibitor; OS: Overall survival; RFS: Recurrence-free survival; HCC: Hepatocellular carcinoma; RFA: Radiofrequency ablation; CRLM: Colorectal liver metastases; RCT: Randomised controlled trial; MWA: Microwave ablation; SBRT: Stereotactic body radiotherapy.

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Citation: Pham HT, Dong ZY, De Alba M, Cottle C, Zhang MY, Parker JB, Morecroft-Phillipps R, Chaludiya K, Ingram D, Ahmad AN, Zeng Z, Mohseni MM, Zhang ZZ, Rueda Prada L, Ali M, Yang V. Immunotherapy in liver metastases: Challenges, emerging evidence, and future directions. World J Clin Oncol 2026; 17(3): 116093
URL: https://www.wjgnet.com/2218-4333/full/v17/i3/116093.htm
DOI: https://dx.doi.org/10.5306/wjco.v17.i3.116093

Pham HT, Dong ZY, De Alba M, Cottle C, Zhang MY, Parker JB, Morecroft-Phillipps R, Chaludiya K, Ingram D, Ahmad AN, Zeng Z, Mohseni MM, Zhang ZZ, Rueda Prada L, Ali M, Yang V. Immunotherapy in liver metastases: Challenges, emerging evidence, and future directions. World J Clin Oncol 2026; 17(3): 116093 [DOI: 10.5306/wjco.v17.i3.116093]

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