Mechanisms of resistance to immune checkpoint inhibitor therapy in hepatocellular carcinoma: current status and challenges

VernacularTitle:肝细胞癌中免疫检查点抑制剂治疗的抵抗机制：现状与挑战
Author: Penghui LIU ¹ ; Na LI ; Yan DONG ; Lingyun GUO ; Jie MAO
Author Information

1. 兰州大学第二临床医学院，兰州　730030
Publication Type:Journal Article
Keywords: Carcinoma, hepatocellular; Immunotherapy; Immune checkpoint inhibitors; Resistance mechanisms
From: Chinese Journal of Hepatobiliary Surgery 2025;31(2):141-146
CountryChina
Language:Chinese
Abstract: This review is based on the research progress and challenges of immune checkpoint inhibitors (ICIs) in the treatment of hepatocellular carcinoma (HCC). ICIs block the PD-1/PD-L1 and CTLA-4 pathways; thereby reactivate the body’s anti-tumor immune response, providing a new therapeutic option for patients with advanced HCC. However, the effect of ICIs is still compromised by factors such as primary and acquired resistance, immune-related adverse events and tumor microenvironment inhibition. This reveiw deeply analyzes these key mechanisms that affect the efficacy of ICIs, and proposes strategies to optimize the treatment, including combination with targeted therapy, chemotherapy and radiotherapy, modulation of tumor microenvironment, and the development of novel biomarkers. Future research should focus on personalized treatment that integrates the molecular and immunological characteristics of patients to enhance the precision and efficacy of ICIs therapy for patients with HCC.