Hepatocellular carcinoma (HCC) is a highly aggressive disease that is usually diagnosed at an advanced stage. Advanced HCC has limited treatment options and often has a poor prognosis. For the past decade, tyrosine kinase inhibitors have been the only treatments approved for advanced HCC that have shown overall survival (OS) benefits; however, but their clinical efficacy has been limited. Recent trials have demonstrated promising advancements in survival outcomes through immunotherapy-based treatments, such as combinations of immune checkpoint inhibitors (ICIs) with other ICIs, antiangiogenic drugs, and locoregional therapies. The atezolizumab-bevacizumab and durvalumab-tremelimumab (STRIDE) regimen has significantly improved survival rates as a first-line treatment and has become the new standard of care. Therefore, combined treatments for advanced HCC can result in better treatment outcomes owing to their synergistic effects, which requires a multidisciplinary approach. Ongoing studies are examining other therapeutic innovations that can improve disease control and OS rates. Despite improvements in the treatment of advanced HCC, further studies on the optimal treatment selection and sequences, biomarker identification, combination approaches with other therapies, and development of novel immunotherapy agents are required. This review presents the current treatment options and clinical data of the ICI-based combination immunotherapies for advanced HCC from a multidisciplinary perspective.
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Reduced-Dose or Discontinuation of Bevacizumab Might Be Considered after Variceal Bleeding in Patients with Hepatocellular Carcinoma Receiving Atezolizumab/Bevacizumab: Case Reports Kyeong-Min Yeom, Young-Gi Song, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim Medicina.2024; 60(1): 157. CrossRef
Hepatocellular Carcinoma: Advances in Systemic Therapy Insija Ilyas Selene, Merve Ozen, Reema A. Patel Seminars in Interventional Radiology.2024; 41(01): 056. CrossRef
Fatal intratumoral hemorrhage in a patient with hepatocellular carcinoma following successful treatment with atezolizumab/bevacizumab: A case report Kyeong-Hoon Park, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim World Journal of Clinical Cases.2024; 12(22): 5177. CrossRef
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A Potential Pneumothorax Induced by Immune Checkpoint Inhibitors: A Case Report and Literature Review Yoon-E Shin, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim Medicina.2024; 60(10): 1634. CrossRef
Prediction of PD-L1 expression in unresectable hepatocellular carcinoma with gadoxetic acid-enhanced MRI Jun Gu Kang, Kyunghwa Han, Taek Chung, Hyungjin Rhee European Journal of Radiology.2024; 181: 111772. CrossRef
Advances in Understanding Hepatocellular Carcinoma Vasculature: Implications for Diagnosis, Prognostication, and Treatment Hyungjin Rhee, Young Nyun Park, Jin-Young Choi Korean Journal of Radiology.2024; 25(10): 887. CrossRef
Current perspectives on the pharmacological treatment of advanced
hepatocellular carcinoma: a narrative review Hye-Jin Yoo, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim The Ewha Medical Journal.2024;[Epub] CrossRef
Improved survival with second-line hepatic arterial infusion chemotherapy after atezolizumab-bevacizumab failure in hepatocellular carcinoma Ji Yeon Lee, Jaejun Lee, Suho Kim, Jae-sung Yoo, Ji Hoon Kim, Keungmo Yang, Ji Won Han, Jeong Won Jang, Jong Yong Choi, Seung Kew Yoon, Ho Jong Chun, Jung Suk Oh, Pil Soo Sung Frontiers in Oncology.2024;[Epub] CrossRef
The clinical efficacy of local ablative treatment for oligometastasis is widely accepted in most cancers. However, due to limited data, this has not been the case for hepatocellular carcinoma (HCC). Here, we report a case of pulmonary oligometastasis of a huge HCC that was treated by multimodality with liver-directed concurrent chemoradiotherapy (CCRT) plus subsequent resection of the primary lesion and local ablative radiotherapy (RT) for subsequent lung oligometastatic lesions. In this patient, liver-directed CCRT induced significant tumor shrinkage with compensatory hypertrophy of the non-tumor liver, followed by curative resection. Surgical resection of the first and second pulmonary metastatic lesions as well as local ablative RT of the third lesion achieved complete tumor regression, which led to long-term survival of 6 years. Therefore, the active use of local ablative RT requires full consideration in cases of oligometastatic HCC.