Immunotherapy in Hepatocellular Carcinoma with Portal Vein Tumour Thrombosis: From Poor Prognosis to Curative-Intent Strategies
, Rodolfo Sacco 2, Luisa Siciliani 3, Saveria Lory Crocè 4,5, Mauro Giuffrè 4, Cristina Stasi 6, Chiara Turri 1, Monica Zoeschg 1 and Andrea Mega 1,â€
on behalf of the A.I.G.O. (Italian Association of Hospital Gastroenterologists) and C.L.E.O. (Italian Association of Hospital Hepatologists)
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
Dear Dr.
Editor,
Overall recommendation:
Accept after minor change
Final comments:
The authors described recent advance in HCC therapies with portal vein tumor thrombosis. Because HCC have heterogeneous genetic characterizations, personalized combination therapy will be very important. The context is very interesting and paper is well written.
Some patients are very effective for immunotherapies, but some are not. It is very important to determine whether current treatment is effective or not. Please discuss when and how to determine the effectiveness of TACE, HAIC, RT, and immunotherapies.
Author Response
We sincerely thank you for your positive evaluation of our manuscript and for highlighting the importance of personalized combination therapy in hepatocellular carcinoma (HCC) with portal vein tumor thrombosis. We greatly appreciate your insightful comment regarding the need to determine treatment effectiveness, particularly given the heterogeneous response to immunotherapies.
Currently, there is not much data available on the response of patients with neoplastic portal vein thrombosis to immunotherapy. However, as this is a very interesting topic and could be important for treatment selection, we have included this data in the Future Directions section along with the available data.
We believe this additional discussion strengthens the clinical relevance of the manuscript and addresses the critical issue of response heterogeneity and timely treatment adaptation.
Reviewer 2 Report
Comments and Suggestions for Authors
I have not found any drawbacks, very informative, clearly written. Minor remarks: please add the list abbreviations, correct the title and the list of authors (see pdf).
Comments for author File: 
Comments.pdf
Author Response
Dear Reviewer,
We sincerely thank you for your positive and encouraging comments on our manuscript. We greatly appreciate your careful review and helpful suggestions.
In response to your minor remarks, we have made the following revisions:
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A list of abbreviations has been added to the manuscript for clarity and ease of reference.
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The title has been corrected as suggested.
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The list of authors who are members of AIGO and CLEO has been included in a Word document.
We believe these changes further improve the clarity and presentation of the manuscript. Thank you again for your valuable feedback and time.
