Immune Therapies

Excerpt

Hepatocellular carcinoma (HCC) is considered an inflammation-induced cancer as it often develops in the setting of chronic hepatitis. Therefore, the application of immune-based therapies may provide an ideal approach to treatment. As a matter of fact, hepatitis B vaccination can be seen as the first preventive cancer vaccine for HCC. The recent approval of nivolumab as second-line therapy for patients with advanced HCC has been the pinnacle of years of research and clinical trials in the application of immunotherapies to patients with HCC. The liver, unlike most organs, has an immune-tolerant microenvironment due to its high antigen exposure from the gut which is often coupled with chronic immune stimulation from confounding liver disease. As a result, efforts to understand HCC antigens as well as the tumor microenvironment has enabled advances in the application of immunotherapies to HCC. Immune-based therapies can be categorized as checkpoint inhibitors, adoptive cell transfer, cytokine-based therapy, and vaccines. In this chapter, we discuss the application of different immunotherapies to HCC.