Krishnan A, Mukherjee D. Letter to the Editor: High-frequency irreversible electroporation as an immune primer in hepatocellular carcinoma. World J Gastroenterol 2026; 32(37): 120765 [DOI: 10.3748/wjg.120765]
Corresponding Author of This Article
Arunkumar Krishnan, MD, Department of Supportive Oncology, Atrium Health Levine Cancer, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, 1021 Morehead Medical Dr, Charlotte, NC 28204, United States. dr.arunkumar.krishnan@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
letter
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Krishnan A, Mukherjee D. Letter to the Editor: High-frequency irreversible electroporation as an immune primer in hepatocellular carcinoma. World J Gastroenterol 2026; 32(37): 120765 [DOI: 10.3748/wjg.120765]
World J Gastroenterol. Oct 7, 2026; 32(37): 120765 Published online Oct 7, 2026. doi: 10.3748/wjg.120765
Letter to the Editor: High-frequency irreversible electroporation as an immune primer in hepatocellular carcinoma
Arunkumar Krishnan, Diptasree Mukherjee
Arunkumar Krishnan, Diptasree Mukherjee, Department of Supportive Oncology, Atrium Health Levine Cancer, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Charlotte, NC 28204, United States
Author contributions: Krishnan A conceptualized the manuscript and conducted the assessment; Krishnan A and Mukherjee D prepared the manuscript draft, which was subsequently reviewed and approved for final publication.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Arunkumar Krishnan, MD, Department of Supportive Oncology, Atrium Health Levine Cancer, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, 1021 Morehead Medical Dr, Charlotte, NC 28204, United States. dr.arunkumar.krishnan@gmail.com
Received: March 9, 2026 Revised: April 14, 2026 Accepted: April 24, 2026 Published online: October 7, 2026 Processing time: 178 Days and 12.8 Hours
Core Tip
Core Tip: High-frequency irreversible electroporation induces features consistent with immunogenic cell death in hepatocellular carcinoma tumors and, when combined with the small-molecule programmed death-1/programmed death-ligand 1 interaction inhibitor BMS-1 and TLR7/8 agonist resiquimod, reverses immunosuppression both locally and systemically. While this triple combination shows strong preclinical efficacy, including a robust abscopal effect, important limitations, such as dependence on a subcutaneous ectopic model, single-timepoint immune profiling, and lack of immune memory validation, need to be addressed before moving to clinical trials. Future research should focus on validating orthotopic models, conducting longitudinal immune studies, performing tumor rechallenge experiments, and optimizing nanoparticle drug delivery as important steps toward a Phase I trial in unresectable hepatocellular carcinoma.
