Challenges and opportunities in the clinical development of immune checkpoint inhibitors for hepatocellular carcinoma
File(s)Flynn_et_al-2018-Hepatology.pdf (745.49 KB)
Accepted version
Author(s)
Flynn, Michael J
Sayed, Anwar A
Sharma, Rohini
Siddique, Abdul
Pinato, David J
Type
Journal Article
Abstract
After a decade of stagnation in drug development, therapeutic reversal of immune-exhaustion with immune checkpoint inhibitors (ICPI) has been shown to be effective in advanced hepatocellular carcinoma (HCC). The clinical development of novel ICPIs continues at a rapid pace, with more than 50 clinical trials of immunotherapeutic agents registered as of May 2018 for this indication. The development of ICPI is particularly challenging in patients with HCC, a population with unique features which impact on safety and efficacy of immune-modulating therapies. In this review, we discuss the biologic foundations supporting the development of ICPI across the advancing stages of HCC, focusing in particular on the proposal of a rational positioning of ICPI across the various Barcelona-Clinic Liver Cancer stages of the disease. Translational studies should guide adequate prioritisation of those therapeutic agents and combination strategies which are most likely to achieve patient benefit based on solid mechanistic and clinical justifications.
Date Issued
2019-05-01
Date Acceptance
2018-10-19
Citation
Hepatology, 2019, 69 (5), pp.2258-2270
ISSN
0270-9139
Publisher
Wiley
Start Page
2258
End Page
2270
Journal / Book Title
Hepatology
Volume
69
Issue
5
Copyright Statement
© 2018 American Association for the Study of Liver Diseases. This is the accepted version of the following article: Flynn, M. J., Sayed, A. A., Sharma, R. , Siddique, A. and Pinato, D. J. (2018), Challenges and opportunities in the clinical development of immune checkpoint inhibitors for hepatocellular carcinoma. Hepatology., which has been published in final form at https://dx.doi.org/10.1002/hep.30337.
Sponsor
Cancer Research UK
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30382576
Grant Number
26137
Subjects
antiangiogenics
biomarkers
cirrhosis
hepatocellular carcinoma
immune-checkpoint inhibitors
loco-regional therapies
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2018-11-01