Abstract:
Hepatocellular carcinoma (HCC) is one of the most common malignancies and the third leading cause of cancer-related mortality globally. Despite significant advances in diagnosis and treatment, the best treatment for early-stage HCC is surgical resection and liver transplantation. However, due to the high recurrence and metastasis rates after surgery, the long-term survival of patients remains challenging. In recent years, immunotherapy—represented by immune checkpoint inhibitors (ICIs)—has offered new opportunities for the treatment of advanced HCC, with a favorable safety profile and encouraging objective responsiveness. Thus, it has emerged as a promising candidate for the development of effective neoadjuvant therapies. The use of immunotherapy in a neoadjuvant setting to increase the efficacy of HCC treatment is currently a hot research topic. However, there are many issues that need to be addressed, such as the timing and duration of neoadjuvant immunotherapy, the criteria used to evaluate its effectiveness, screening target populations to identify those suitable for treatment, and the safety and hepatotoxicity of the treatment. In this review, we summarize the current literature and clinical trials on neoadjuvant immunotherapy for HCC, present an analysis of these data, and suggest future prospects.