TY - JOUR
T1 - Non-alcoholic fatty liver disease-related hepatocellular carcinoma
T2 - Is there a role for immunotherapy?
AU - Mattos, Ângelo Z.
AU - Debes, Jose D.
AU - Vogel, Arndt
AU - Arrese, Marco
AU - Revelo, Xavier
AU - Pase, Tales Henrique S.
AU - Manica, Muriel
AU - Mattos, Angelo A.
N1 - Publisher Copyright: ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2022/7/28
Y1 - 2022/7/28
N2 - Hepatocellular carcinoma (HCC) is among the most common cancers and it is a major cause of cancer-related deaths. Non-alcoholic fatty liver disease (NAFLD) affects approximately one fourth of individuals worldwide and it is becoming one of the most important causes of HCC. The pathogenic mechanisms leading to NAFLD-related HCC are complex and not completely understood. However, metabolic, fibrogenic, oncogenic, inflammatory and immunological pathways seem to be involved. First-line therapy of advanced HCC has recently undergone major changes, since the combination of atezolizumab and bevacizumab was proven to increase survival when compared to sorafenib. Other immune-oncology drugs are also demonstrating promising results in patients with advanced HCC when compared to traditional systemic therapy. However, initial studies raised concerns that the advantages of immunotherapy might depend on the underlying liver disease, which seems to be particularly important in NAFLD-related HCC, as these tumors might not benefit from it. This article will review the mechanisms of NAFLD-related hepatocarcinogenesis, with an emphasis on its immune aspects, the efficacy of traditional systemic therapy for advanced NAFLD-related HCC, and the most recent data on the role of immunotherapy for this specific group of patients, showing that the management of this condition should be individualized and that a general recommendation cannot be made at this time.
AB - Hepatocellular carcinoma (HCC) is among the most common cancers and it is a major cause of cancer-related deaths. Non-alcoholic fatty liver disease (NAFLD) affects approximately one fourth of individuals worldwide and it is becoming one of the most important causes of HCC. The pathogenic mechanisms leading to NAFLD-related HCC are complex and not completely understood. However, metabolic, fibrogenic, oncogenic, inflammatory and immunological pathways seem to be involved. First-line therapy of advanced HCC has recently undergone major changes, since the combination of atezolizumab and bevacizumab was proven to increase survival when compared to sorafenib. Other immune-oncology drugs are also demonstrating promising results in patients with advanced HCC when compared to traditional systemic therapy. However, initial studies raised concerns that the advantages of immunotherapy might depend on the underlying liver disease, which seems to be particularly important in NAFLD-related HCC, as these tumors might not benefit from it. This article will review the mechanisms of NAFLD-related hepatocarcinogenesis, with an emphasis on its immune aspects, the efficacy of traditional systemic therapy for advanced NAFLD-related HCC, and the most recent data on the role of immunotherapy for this specific group of patients, showing that the management of this condition should be individualized and that a general recommendation cannot be made at this time.
UR - http://www.scopus.com/inward/record.url?scp=85135010781&partnerID=8YFLogxK
U2 - 10.3748/wjg.v28.i28.3595
DO - 10.3748/wjg.v28.i28.3595
M3 - Review article
C2 - 36161041
AN - SCOPUS:85135010781
SN - 1007-9327
VL - 28
SP - 3595
EP - 3607
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
IS - 28
ER -