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Abstract Details
Optimizing the Combination of Immunotherapy and Trans-Arterial Locoregional Therapy for Stages B and C Hepatocellular Cancer
Ann Surg Oncol. 2021 Jan 3. doi: 10.1245/s10434-020-09414-5.Online ahead of print.
Matthew R Woeste12, Anne E Geller12, Robert C G Martin 2nd3, Hiram C Polk Jr1
Author information
1Division of Surgical Oncology, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
2Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, KY, USA.
3Division of Surgical Oncology, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA. robert.martin@louisville.edu.
Abstract
Hepatocellular carcinoma (HCC), the most common primary hepatic malignancy worldwide, is the second leading cause of cancer-related death. Underlying liver dysfunction and advanced stage of disease require treatments to be optimally timed and implemented to minimize hepatic parenchymal damage while maximizing disease response and quality of life. Locoregional therapies (LRTs) such as trans-arterial chemo- and radio-embolization remain effective for intermediate liver-only and advanced HCC disease (i.e., Barcelona-Clinic liver cancer stages B and C) not amendable to primary resection or ablation. Additionally, these minimally invasive interventions have been shown to augment the immune system. This and the recent success of immune-oncologic treatments for HCC have generated interest in applying these therapies in combination with such locoregional interventions to improve patient outcomes and response rates. This report reviews the use of trans-arterial LRTs with immunotherapy for stages B and C HCC, potential biomarkers, and imaging methods for assessing the response and safety of such combinations.