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Review
. 2025 Mar 6;9(1):60.
doi: 10.1038/s41698-025-00846-4.

Neoadjuvant immune checkpoint inhibitors for hepatocellular carcinoma

Vinita Akula  1 , Lily Chen  1 , Yusuf Acikgoz  2 , Katherine Klein  1 , Betul Gok Yavuz  3 , Lokman Cevik  4 , Tarik Demir  5 , Ashish Manne  2 , Ilyas Sahin  6 , Ahmed Kaseb  7 , Elshad Hasanov  8
Affiliations
Review

Neoadjuvant immune checkpoint inhibitors for hepatocellular carcinoma

Vinita Akula et al. NPJ Precis Oncol. .

Abstract

Hepatocellular carcinoma (HCC) is the most common type of liver cancer. HCC treatment is challenging; surgical resection is the primary curative treatment for early-stage disease, but recurrence rates are high. Immune checkpoint inhibitors (ICIs) are a promising neoadjuvant treatment that can reduce recurrence rates and mortality after surgery and achieve complete/partial responses. Clinical trials provide strong evidence for the efficacy and safety of ICI monotherapy for neoadjuvant HCC treatment.

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Conflict of interest statement

Competing interests: A.K. reports receiving grants or contracts from Roche Genentech, Merck, Exelexis, Eisai, Henguri, AdaptImmune. Tvardi, and BMS and consulting fees from Roche Genentech, Merck, Exelexis, Eisai, and BMS. A.M. reports receiving consulting fees from Pfizer and AstraZeneca. E.H. reports receiving OSUCCC-Pelotonia startup funds and honoraria from Target Oncology, and participating on advisory boards for Telix Pharmaceuticals, Pfizer, and Eisai. All other authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1. Mechanisms of Immune Checkpoint Inhibitors on Tumor Microenvironment (TME).
Tumor microenvironments (TME) rich in T-cells and dendritic cells potentiate effects of immune checkpoint inhibitors (ICIs), creating a more robust treatment response. CTLA-4 inhibitors act on the priming phase of T-cell activation while PD-1 inhibitors prevent destruction of activated T-cells. Tumors rich in myeloid-derived suppressor cells have poor response to ICIs. Created in BioRender. Akula, V. (2025) https://BioRender.com/u85l726.
Fig. 2
Fig. 2. The correlation between major pathological response (MPR)/pathologic complete response (pCR) and objective response rate (ORR).
MPR major pathological response, ORR objective response rate, TACE transarterial chemoembolization.
Fig. 3
Fig. 3. The correlation between major pathological response (MPR)/ pathologic complete response (pCR) and treatment-related adverse events.
MPR major pathological response, TACE transarterial chemoembolization, TRAEs treatment related adverse events.
See this image and copyright information in PMC

References

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