[Perioperative Immunotherapy as a Strategy to Overcome Hepatocellular Carcinoma].

Le résumé fourni par la source

Hepatocellular carcinoma (HCC) has a high recurrence rate even after curative resection or local ablation, and early recurrence within 1-2 years is often driven by intrahepatic metastasis and strongly affects prognosis. Immune checkpoint inhibitor (ICI)-based combination therapy has become a standard approach for unresectable advanced HCC, prompting efforts to extend immunotherapy to earlier-stage disease. Neoadjuvant immunotherapy may induce systemic antitumor immunity while tumor antigens remain abundant. However, definitive phase Ⅲ evidence for neoadjuvant therapy alone is lacking. In the adjuvant setting, large phase Ⅲ trials, including IMbrave050 and KEYNOTE-937, failed to show a sustained reduction in recurrence, highlighting the limitations of postoperative immunotherapy alone. In contrast, the phase Ⅲ CARES-009 trial, which connected neoadjuvant and adjuvant treatment into a perioperative strategy, reported suppression of postoperative recurrence, although longer follow-up is still required for a definitive evaluation. As a vaccine-based perioperative immunotherapy distinct from ICIs, we also demonstrated the safety of perioperative administration in resectable HCC and the potential to enhance intratumoral CD8-positive T-cell infiltration. In this review, we summarize the biological rationale and the principal clinical trial results of perioperative immunotherapy for resectable HCC, and outline its current positioning and future prospects.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.