Advancement in systemic therapy, particularly immune checkpoint inhibitor (ICI)-based
combination regimens, has transformed the treatment landscape for patients with advanced
hepatocellular carcinoma (HCC). The advancement in systemic therapy also provides
new opportunities of reducing recurrence after curative therapy through adjuvant therapy
or improving resectability through neoadjuvant therapy. Improved recurrence-free survival
by adjuvant or neoadjuvant ICI-based therapy has been reported in other cancer types.
In this article, developments of systemic therapy in adjuvant and neoadjuvant settings
for HCC were reviewed. The design of adjuvant and neoadjuvant therapy using ICI-based
regimens and potential challenges of trial conduct and result analysis was discussed.
Results from these trials may extend the therapeutic benefit of ICI-based systemic
therapy beyond the advanced-stage disease and lead to a new era of multidisciplinary
management for HCC.
Keywords
antiangiogenic - biomarkers - cytotoxic T-lymphocyte-associated protein 4 (CTLA4)
- program cell death-1 (PD-1) - tumor microenvironment
