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Challenges and Future Trends of Hepatocellular Carcinoma Immunotherapy, 2nd Edition

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Immunology".

Deadline for manuscript submissions: closed (20 November 2024) | Viewed by 5309

Special Issue Editor


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Guest Editor
Medical Oncology Unit, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy
Interests: hepatocellular carcinoma; immunotherapy; gastric cancer; HCC; renal cell carcinoma; urothelial carcinoma; biliary tract cancer; cholangiocarcinoma
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Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Emerging immune checkpoint inhibitors (ICIs) have also made progress in HCC, with two PD-1 inhibitors—nivolumab and pembrolizumab—both being approved by the United States Food and Drug Administration (FDA). ICIs alone as a first-line treatment have not achieved the desired effect; however, clinical trials evaluating combinatorial strategies involving ICIs and other anticancer agents, especially antiangiogenic agents, have produced more compelling results, marking a new era in HCC management. The Practice-Changing Phase III IMbrave150 Trial compared the use of a combination of the PD-L1 inhibitor atezolizumab and bevacizumab versus sorafenib monotherapy in treatment-naïve patients with advanced HCC and showed that combination therapy resulted in higher median overall survival (OS), median progression-free survival (PFS) benefit, and overall response rate (ORR). Atezolizumab–bevacizumab is also currently recognized as the new standard of care in front-line HCC and has been approved for use in several countries worldwide. Similarly, other combinations have been tested and are currently being evaluated.

From this point of view, this Special Issue welcomes basic research, reviews, case reports, etc., on the current state of the art in the immunotherapy of HCC.

Potential topics include, but are not limited to:

  • Translational research;
  • Molecular experiments on novel immune-based combinations;
  • Real-world experience with immune checkpoint inhibitors;
  • Fighting resistance to immune checkpoint inhibitors;
  • Biomarker-driven studies.

Dr. Angela Dalia Ricci
Guest Editor

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Keywords

  • liver cancer
  • hepatocellular carcinoma
  • immunotherapy
  • immune checkpoint inhibitors
  • atezolizumab

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Published Papers (3 papers)

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Review

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18 pages, 16683 KiB  
Review
Immune Microenvironment and the Effect of Vascular Endothelial Growth Factor Inhibition in Hepatocellular Carcinoma
by Kyoko Oura, Asahiro Morishita, Tomoko Tadokoro, Koji Fujita, Joji Tani and Hideki Kobara
Int. J. Mol. Sci. 2024, 25(24), 13590; https://doi.org/10.3390/ijms252413590 - 19 Dec 2024
Cited by 4 | Viewed by 1325
Abstract
Systemic therapy for unresectable hepatocellular carcinoma (HCC) has progressed with the development of multiple kinases, such as vascular endothelial growth factor (VEGF) signaling, targeting cancer growth and angiogenesis. Additionally, the efficacy of sorafenib, regorafenib, lenvatinib, ramucirumab, and cabozantinib has been demonstrated in various [...] Read more.
Systemic therapy for unresectable hepatocellular carcinoma (HCC) has progressed with the development of multiple kinases, such as vascular endothelial growth factor (VEGF) signaling, targeting cancer growth and angiogenesis. Additionally, the efficacy of sorafenib, regorafenib, lenvatinib, ramucirumab, and cabozantinib has been demonstrated in various clinical trials, and they are now widely used in clinical practice. Furthermore, the development of effective immune checkpoint inhibitors has progressed in systemic therapy for unresectable HCC, and atezolizumab + bevacizumab (atezo/bev) therapy and durvalumab + tremelimumab therapy are now recommended as first-line treatment. Atezo/bev therapy, which combines an anti-programmed cell death 1 ligand 1 antibody with an anti-VEGF antibody, is the first cancer immunotherapy to demonstrate efficacy against unresectable HCC. With the increasing popularity of these treatments, VEGF inhibition is attracting attention from the perspective of its anti-angiogenic effects and impact on the cancer-immune cycle. In this review, we outline the role of VEGF in the tumor immune microenvironment and cancer immune cycle in HCC and outline the potential immune regulatory mechanisms of VEGF. Furthermore, we consider the potential significance of the dual inhibition of angiogenesis and immune-related molecules by VEGF, and ultimately aim to clarify the latest treatment strategies that maximizes efficacy. Full article
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25 pages, 813 KiB  
Review
Immune Checkpoint Inhibitors in the Pre-Transplant Hepatocellular Carcinoma Setting: A Glimpse Beyond the Liver
by Luca Marzi, Andrea Mega, Chiara Turri, Stefano Gitto, Federica Ferro and Gilbert Spizzo
Int. J. Mol. Sci. 2024, 25(21), 11676; https://doi.org/10.3390/ijms252111676 - 30 Oct 2024
Cited by 1 | Viewed by 1363
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of cancer-related death worldwide. Liver transplantation (LT) is the best therapy for most patients with non-metastatic HCC. In recent years, the management of patients with HCC has considerably [...] Read more.
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of cancer-related death worldwide. Liver transplantation (LT) is the best therapy for most patients with non-metastatic HCC. In recent years, the management of patients with HCC has considerably changed, thanks to the improvement of molecular biology knowledge and the introduction of immunotherapy. To date, systemic therapy is authorized in the Western world only in patients with advanced HCC. However, this therapy could not only stabilize the tumour disease or improve survival but could display excellent response and lead to downstaging of the tumour that finally permits LT. There are increasing reports of patients that have performed LT after pretreatment with immune checkpoint inhibitors (ICIs). However, due to the intrinsic mechanism of ICIs, graft rejection might be favoured. In addition, chronic adverse effects affecting other organs may also appear after the end of therapy. This review aims to evaluate the readiness and outcomes of LT in patients with advanced HCC who have previously undergone treatment with ICIs. It seeks to identify the challenges, risks, and benefits associated with this conversion therapy. The integration of ICIs into the treatment paradigm for advanced HCC necessitates a nuanced approach to LT. While early evidence supports the feasibility of LT following ICIs therapy, there is an urgent need for standardized guidelines and more extensive longitudinal studies to optimize patient selection, timing, and post-transplant management. Full article
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12 pages, 954 KiB  
Perspective
Hepatocellular Carcinoma Immunotherapy: Predictors of Response, Issues, and Challenges
by Alessandro Rizzo, Oronzo Brunetti and Giovanni Brandi
Int. J. Mol. Sci. 2024, 25(20), 11091; https://doi.org/10.3390/ijms252011091 - 15 Oct 2024
Cited by 4 | Viewed by 2108
Abstract
Immune checkpoint inhibitors (ICIs), such as durvalumab, tremelimumab, and atezolizumab, have emerged as a significant therapeutic option for the treatment of hepatocellular carcinoma (HCC). In fact, the efficacy of ICIs as single agents or as part of combination therapies has been demonstrated in [...] Read more.
Immune checkpoint inhibitors (ICIs), such as durvalumab, tremelimumab, and atezolizumab, have emerged as a significant therapeutic option for the treatment of hepatocellular carcinoma (HCC). In fact, the efficacy of ICIs as single agents or as part of combination therapies has been demonstrated in practice-changing phase III clinical trials. However, ICIs confront several difficulties, including the lack of predictive biomarkers, primary and secondary drug resistance, and treatment-related side effects. Herein, we provide an overview of current issues and future challenges in this setting. Full article
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