Delivering adjuvant and neoadjuvant treatments in the early stages of hepatocellular carcinoma

Expert Rev Gastroenterol Hepatol. 2024 Oct;18(10):647-660. doi: 10.1080/17474124.2024.2419519. Epub 2024 Oct 22.

Abstract

Introduction: Hepatocellular carcinoma (HCC) presents a formidable challenge in oncology, demanding innovative treatment approaches. Both adjuvant and neoadjuvant therapies, thanks to the introduction of immunotherapy, have emerged as promising strategies in the management of HCC, aiming to reduce the risk of relapse and ultimately to improve survival.

Areas covered: This review considers current evidence, ongoing clinical trials, and future strategies to elucidate the evolving landscape of neoadjuvant and adjuvant treatments in HCC.

Expert opinion: Both adjuvant and neoadjuvant regimens, notably those incorporating immune checkpoint inhibitors, demonstrated encouraging safety profiles and efficacy outcomes in HCC.While significant challenges persist, including optimizing patient selection and endpoint definition, the evolving landscape of neoadjuvant and adjuvant therapy holds promise for maximizing the therapeutic potential of immunotherapy across all stages of HCC. Further insights into tumor biology and host immunity will shape the role of these approaches which are close to becoming reality in clinical practice.

Keywords: Immunotherapy; adjuvant; hepatocellular carcinoma; immune checkpoint inhibitors; neoadjuvant.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular* / immunology
  • Carcinoma, Hepatocellular* / pathology
  • Carcinoma, Hepatocellular* / therapy
  • Chemotherapy, Adjuvant
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunotherapy / methods
  • Liver Neoplasms* / immunology
  • Liver Neoplasms* / pathology
  • Liver Neoplasms* / therapy
  • Neoadjuvant Therapy*
  • Neoplasm Recurrence, Local
  • Neoplasm Staging

Substances

  • Immune Checkpoint Inhibitors