Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.253
Peer-review started: June 11, 2015
First decision: July 14, 2015
Revised: August 11, 2015
Accepted: October 26, 2015
Article in press: October 26, 2015
Published online: January 7, 2016
Hepatocellular carcinoma (HCC) is a frequent cancer with a high mortality. For early stage cancer there are potentially curative treatments including local ablation, resection and liver transplantation. However, for more advanced stage disease, there is no optimal treatment available. Even in the case of a “curative” treatment, recurrence or development of a new cancer in the precancerous liver is common. Thus, there is an urgent need for novel and effective (adjuvant) therapies to treat HCC and to prevent recurrence after local treatment in patients with HCC. The unique immune response in the liver favors tolerance, which remains a genuine challenge for conventional immunotherapy in patients with HCC. However, even in this “immunotolerant” organ, spontaneous immune responses against tumor antigens have been detected, although they are insufficient to achieve significant tumor death. Local ablation therapy leads to immunogenic tumor cell death by inducing the release of massive amounts of antigens, which enhances spontaneous immune response. New immune therapies such as dendritic cell vaccination and immune checkpoint inhibition are under investigation. Immunotherapy for cancer has made huge progress in the last few years and clinical trials examining the use of immunotherapy to treat hepatocellular carcinoma have shown some success. In this review, we discuss the current status of and offer some perspectives on immunotherapy for hepatocellular carcinoma, which could change disease progression in the near future.
Core tip: Hepatocellular carcinoma is a frequent cancer with a high mortality. For early stage cancer there are potentially curative treatments including local ablation, resection and liver transplantation. However, recurrence or development of a new tumor after treatment are not uncommon. Moreover, for more advanced stage disease, there is no optimal treatment available. Thus, there is an urgent need for novel and effective therapies for advanced stage hepatocellular carcinoma, and to prevent and to treat recurrence after local treatment of hepatocellular carcinoma.