The incidence rate and mortality of hepatocellular carcinoma are still very high. Surgery, ablation therapy, and liver transplantation are crucial in the treatment of liver cancer, but they are prone to recurrence after surgery; In addition, hepatocellular carcinoma is often diagnosed in advanced stages, which makes systemic therapy, especially immunotherapy, an important treatment option. The immune microenvironment of liver cancer has immunosuppressive effects, and overcoming immunosuppression is the key to immunotherapy for the liver cancer. In recent years, multiple clinical trials have shown that immunotherapy, especially the combination of immune checkpoint inhibitors, has better efficacy and survival rates, making it the gold standard for treating patients with advanced hepatocellular carcinoma. This success has prompted research to expand the application of immunotherapy to neoadjuvant, adjuvant, and conversion therapies, as well as patients with liver dysfunction and those awaiting liver transplantation. Although its efficacy has been proven, there are still a large number of patients who develop resistance to immunotherapy, which requires various innovative strategies to address this challenge.

The incidence rate and mortality of hepatocellular carcinoma are still very high. Surgery, ablation therapy, and liver transplantation are crucial in the treatment of liver cancer, but they are prone to recurrence after surgery; In addition, hepatocellular carcinoma is often diagnosed in advanced stages, which makes systemic therapy, especially immunotherapy, an important treatment option. The immune microenvironment of liver cancer has immunosuppressive effects, and overcoming immunosuppression is the key to immunotherapy for the liver cancer. In recent years, multiple clinical trials have shown that immunotherapy, especially the combination of immune checkpoint inhibitors, has better efficacy and survival rates, making it the gold standard for treating patients with advanced hepatocellular carcinoma. This success has prompted research to expand the application of immunotherapy to neoadjuvant, adjuvant, and conversion therapies, as well as patients with liver dysfunction and those awaiting liver transplantation. Although its efficacy has been proven, there are still a large number of patients who develop resistance to immunotherapy, which requires various innovative strategies to address this challenge.