Different immunological microenvironment in patients with different cirrhosis etiology and hepatocellular carcinoma

Introduction: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death. Most cases (90%) of HCC arise in the setting of a chronic liver disease. The advanced stages of HCC are amendable only to systemic treatment. Systemic therapy has been revolutionized by immune-based therapies. However, a recent meta-analysis of three randomized phase III clinical trials that tested inhibitors of PD-L1 or PD1 in more than 1,600 patients with advanced HCC, revealed that immune therapy did not improve survival in patients with non-viral HCC.