Author information
1 Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy. vito.longo79@tiscali.it.
2 Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy. dr.oronzo.brunetti@tiscali.it.
3 Medical Oncology Unit, "S. Cuore di Gesù" Hospital, 73014Gallipoli, Italy. drgnoni.antonio@libero.it.
4 Medical Oncology Unit, "S. Cuore di Gesù" Hospital, 73014Gallipoli, Italy. antonellalicchetta@libero.it.
5 Scientific Direction, IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy. delcuratolo.sa@gmail.com.
6 Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", 70124 Bari, Italy. drmemeo@yahoo.it.
7 Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy. antoniogiovannisolimando@gmail.com.
8 Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine "G. Baccelli", University of Bari "Aldo Moro", Bari 70124, Italy. antoniogiovannisolimando@gmail.com.
9 Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy. argentieroantonella@gmail.com.
Abstract
Hepatocellular carcinoma is the most common primary liver cancer and the fourth leading cause of cancer death worldwide. A total of 70-80% of patients are diagnosed at an advanced stage with a dismal prognosis. Sorafenib had been the standardcare for almost a decade until 2018 when the Food and Drug Administration approved an alternative first-line agent namely lenvatinib. Cabozantinib, regorafenib, and ramucirumab also displayed promising results in second line settings. FOLFOX4, however, results inan alternative first-line treatment for the Chineseclinical oncology guidelines. Moreover,nivolumab and pembrolizumab,two therapeutics against the Programmed death (PD)-ligand 1 (PD-L1)/PD1 axis have been recently approvedfor subsequent-line therapy. However, similar to other solid tumors, the response rate of single agent targeting PD-L1/PD1 axis is low. Therefore, a lot of combinatory approaches are under investigation, including the combination of different immune checkpoint inhibitors (ICIs), the addition of ICIs after resection or during loco-regional therapy, ICIs in addition to kinase inhibitors, anti-angiogenic therapeutics, and others. This review focuses on the use of ICIs for the hepatocellular carcinoma with a careful assessmentof new ICIs-based combinatory approaches.