Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinoma

The use of immune checkpoint inhibitors (ICIs) targeting PD-L1/PD-1 and CTLA-4 has transformed the oncology practice of hepatocellular carcinoma. However, only 25–30% of the patients with advanced HCC treated with atezolizumab-bevacizumab or tremelimumab-durvalumab (STRIDE) respond initially, and me...

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Main Authors: Benjamin Koh, Darren Jun Hao Tan, Wen Hui Lim, Jeffrey S L Wong, Cheng Han Ng, Kai En Chan, Meng Wang, Wei Peng Yong, Yock Young Dan, Louis Z Wang, Nigel Tan, Mark Muthiah, Alfred Kow, Nicholas L. Syn, Daniel Q. Huang, Thomas Yau
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:OncoImmunology
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Online Access:https://www.tandfonline.com/doi/10.1080/2162402X.2023.2214478
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author Benjamin Koh
Darren Jun Hao Tan
Wen Hui Lim
Jeffrey S L Wong
Cheng Han Ng
Kai En Chan
Meng Wang
Wei Peng Yong
Yock Young Dan
Louis Z Wang
Nigel Tan
Mark Muthiah
Alfred Kow
Nicholas L. Syn
Daniel Q. Huang
Thomas Yau
author_facet Benjamin Koh
Darren Jun Hao Tan
Wen Hui Lim
Jeffrey S L Wong
Cheng Han Ng
Kai En Chan
Meng Wang
Wei Peng Yong
Yock Young Dan
Louis Z Wang
Nigel Tan
Mark Muthiah
Alfred Kow
Nicholas L. Syn
Daniel Q. Huang
Thomas Yau
author_sort Benjamin Koh
collection DOAJ
description The use of immune checkpoint inhibitors (ICIs) targeting PD-L1/PD-1 and CTLA-4 has transformed the oncology practice of hepatocellular carcinoma. However, only 25–30% of the patients with advanced HCC treated with atezolizumab-bevacizumab or tremelimumab-durvalumab (STRIDE) respond initially, and mechanistic biomarkers and novel treatment strategies are urgently needed for patients who present with or acquire resistance to first-line ICI-based therapies. The recent approval of the STRIDE regimen has also engendered new questions, such as patient selection factors (e.g. portal hypertension and history of variceal bleed) and biomarkers, and the optimal combination and sequencing of ICI-based regimens. Triumphs in the setting of advanced HCC have also galvanized considerable interest in the broader application of ICIs to early- and intermediate-stage diseases, including clinical combination of ICIs with locoregional therapies. Among these clinical contexts, the role of ICIs in liver transplantation – which is a potentially curative strategy unique to HCC management – as a bridge to liver transplant in potential candidates or in the setting of post-transplant recurrence, warrants investigation in view of the notable theoretical risk of allograft rejection. In this review, we summarize and chart the landscape of seminal immuno-oncology trials in HCC and envision future clinical developments.
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spelling doaj-art-98077533239642c291b0017f7ac496352025-08-20T02:01:30ZengTaylor & Francis GroupOncoImmunology2162-402X2023-12-0112110.1080/2162402X.2023.2214478Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinomaBenjamin Koh0Darren Jun Hao Tan1Wen Hui Lim2Jeffrey S L Wong3Cheng Han Ng4Kai En Chan5Meng Wang6Wei Peng Yong7Yock Young Dan8Louis Z Wang9Nigel Tan10Mark Muthiah11Alfred Kow12Nicholas L. Syn13Daniel Q. Huang14Thomas Yau15Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Special Administrative Region, ChinaYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDivision of Advanced Internal Medicine, Department of Medicine, National University Hospital, Singapore, SingaporeDepartment of Haematology-Oncology, National University Cancer Institute, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeSingHealth Internal Medicine Residency Programme, Singapore General Hospital, Singapore, SingaporeNational University Centre for Organ Transplantation, National University Health System, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Special Administrative Region, ChinaThe use of immune checkpoint inhibitors (ICIs) targeting PD-L1/PD-1 and CTLA-4 has transformed the oncology practice of hepatocellular carcinoma. However, only 25–30% of the patients with advanced HCC treated with atezolizumab-bevacizumab or tremelimumab-durvalumab (STRIDE) respond initially, and mechanistic biomarkers and novel treatment strategies are urgently needed for patients who present with or acquire resistance to first-line ICI-based therapies. The recent approval of the STRIDE regimen has also engendered new questions, such as patient selection factors (e.g. portal hypertension and history of variceal bleed) and biomarkers, and the optimal combination and sequencing of ICI-based regimens. Triumphs in the setting of advanced HCC have also galvanized considerable interest in the broader application of ICIs to early- and intermediate-stage diseases, including clinical combination of ICIs with locoregional therapies. Among these clinical contexts, the role of ICIs in liver transplantation – which is a potentially curative strategy unique to HCC management – as a bridge to liver transplant in potential candidates or in the setting of post-transplant recurrence, warrants investigation in view of the notable theoretical risk of allograft rejection. In this review, we summarize and chart the landscape of seminal immuno-oncology trials in HCC and envision future clinical developments.https://www.tandfonline.com/doi/10.1080/2162402X.2023.2214478Hepatocellular carcinomaimmune checkpoint blockadeNeoadjuvant immunotherapyprecision immunotherapytransplant oncologytumor microenvironment
spellingShingle Benjamin Koh
Darren Jun Hao Tan
Wen Hui Lim
Jeffrey S L Wong
Cheng Han Ng
Kai En Chan
Meng Wang
Wei Peng Yong
Yock Young Dan
Louis Z Wang
Nigel Tan
Mark Muthiah
Alfred Kow
Nicholas L. Syn
Daniel Q. Huang
Thomas Yau
Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinoma
OncoImmunology
Hepatocellular carcinoma
immune checkpoint blockade
Neoadjuvant immunotherapy
precision immunotherapy
transplant oncology
tumor microenvironment
title Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinoma
title_full Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinoma
title_fullStr Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinoma
title_full_unstemmed Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinoma
title_short Trial watch: immunotherapeutic strategies on the horizon for hepatocellular carcinoma
title_sort trial watch immunotherapeutic strategies on the horizon for hepatocellular carcinoma
topic Hepatocellular carcinoma
immune checkpoint blockade
Neoadjuvant immunotherapy
precision immunotherapy
transplant oncology
tumor microenvironment
url https://www.tandfonline.com/doi/10.1080/2162402X.2023.2214478
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