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"Immunotherapy"

Original Article

Integrative multi-omics profiling identifies infiltrative hepatocellular carcinoma as an immunotherapy-resistant subtype with distinct molecular features
Won Suk Lee, Seonjeong Woo, Sung Hwan Lee, Gae Hoon Jo, Ilhwan Kim, Hyeyeong Kim, Chansik An, Sanghoon Jung, Gwangil Kim, Haeyoun Kang, Beodeul Kang, Jung Sun Kim, Ho Yeong Lim, Incheon Kang, Hannah Yang, So Jung Kong, Dahyeon Son, Dong Jun Shin, Woo Young Kwon, Da-Yeon Lee, Ju-Seog Lee, Junho Park, Youngsoo Kim, Sohyun Hwang, Chan Kim, Hong Jae Chon
Clin Mol Hepatol 2026;32(1):258-275.
Published online October 27, 2025
DOI: https://doi.org/10.3350/cmh.2025.0792
Background/Aims
Hepatocellular carcinoma (HCC) exhibits substantial morphological and biological heterogeneity. Clinical and molecular relevance of the infiltrative subtype remains poorly defined in the context of cancer immunotherapy. We aimed to evaluate the prognostic impact and molecular features of infiltrative HCC in patients treated with first-line atezolizumab plus bevacizumab (Ate/Bev).
Methods
We included 307 patients with advanced HCC treated with Ate/Bev and classified them into four gross morphological types based on imaging. Multi-omics profiling was conducted on tumor samples. Type IV infiltrative signature was derived and externally validated using five independent HCC cohorts, including IMbrave150.
Results
Infiltrative morphology, encompassing pure and mixed forms, was present in 42.7% of advanced HCC and associated with advanced disease features and compromised liver function. Patients with type IV infiltrative HCC showed lowest
objective
response rate (14.6%) and worst progression-free (median, 2.8 months) and overall survival (median, 7.1 months). Infiltrative morphology remained an independent predictor of poor outcomes after multivariable adjustment for confounders, including intrahepatic tumor extent. Genomic profiling revealed enriched TP53 and ATM loss-of-function mutations in type IV infiltrative HCC. Transcriptomic and proteomic analyses identified consistent activation of tumor proliferation, epithelial-mesenchymal transition, TGF-β signaling, and immunosuppressive pathways in type IV infiltrative HCC. Type IV infiltrative signature was significantly associated with poor survival across external datasets and retained independent prognostic value.
Conclusions
Infiltrative HCC is a clinically aggressive and molecularly distinct subtype of advanced HCC. Morphological classification and type IV infiltrative signatures may guide risk stratification and therapeutic decision-making in advanced HCC treated with immunotherapy.

Citations

Citations to this article as recorded by  Crossref logo
  • Prognostic Significance of Glypican-3 Expression in Hepatocellular Carcinoma Treated with Atezolizumab-Bevacizumab
    Ji Hoon Kim, Ji Won Han, Hee Sun Cho, Jeong Won Jang, Kwon Yong Tak, Pil Soo Sung
    Cancers.2025; 17(24): 3967.     CrossRef
  • 1,200 View
  • 201 Download
  • Crossref

Reviews

Stratifying cholangiocarcinoma: tumor microenvironment, molecular drivers, and novel immunotherapeutic approaches
Cindy Xinqi Liu, Carmen Chak-Lui Wong
Clin Mol Hepatol 2026;32(1):127-155.
Published online October 14, 2025
DOI: https://doi.org/10.3350/cmh.2025.0889
Cholangiocarcinoma (CCA) is an epithelial cell cancer of the biliary tract. CCA can be further classified into intrahepatic cholangiocarcinoma (iCCA), perihilar cholangiocarcinoma (pCCA), and distal cholangiocarcinoma (dCCA) depending on the anatomical location. Until recently, the treatment for advanced CCA has remained highly reliant on chemotherapy, with gemcitabine plus cisplatin used in first-line treatment. Recent developments have led to the addition of immune checkpoint blockade (ICB) to the chemotherapy regimen, highlighting the promising potential of immunotherapies for CCA treatment. Despite these developments, most patients still do not benefit from current treatments, and response rates to ICB monotherapy remain modest. This underscores the need to develop more effective immunotherapeutic strategies. A major obstacle to this is the highly heterogenous nature of the disease. CCA tumors exhibit high inter-tumor heterogeneity in terms of anatomical locations, driver mutations, etiologies, and tumor microenvironment (TME) composition, making each patient immunologically distinct and difficult to benefit from a one-size-fits-all approach. There is a need to stratify patients according to individual disease status to identify immunotherapies and combination therapies that are most beneficial to them. Here we describe the different ways inter-tumor heterogeneity may arise in CCA, including stromal cell abundance, anatomical location, driver mutations, etiologies, TME profile, and tertiary lymphoid structure (TLS) presence. We also discuss what these factors mean to the immune microenvironment and their potential to be used as biomarkers. Careful stratification of patients is crucial in designing personalized medicine to improve survival outcomes and treatment efficacy for CCA patients.
  • 1,126 View
  • 77 Download
Taiwan liver cancer association management consensus guidelines for intermediate-stage hepatocellular carcinoma
I-Cheng Lee, Hung-Wei Wang, Wei Teng, Tsung-Jung Lin, Chien-Hung Chen, Hsueh-Chou Lai, Teng-Yu Lee, Ching-Wei Chang, Chao-Hung Hung, Chia-Yen Dai, Yi-Ping Hung, Ying-Chun Shen, Chien-Wei Su, Ming-Chih Ho, Wei-Chen Lee, Gar-Yang Chau, Chin-Tsung Ting, Po-Chin Liang, Chien-An Liu, Pi-Yi Chang, Kuan-Yang Chen, Shi-Ming Lin, Li-Tzong Chen, Yi-Hsiang Huang, TLCA Intermediate Stage HCC Working Group
Clin Mol Hepatol 2025;31(4):1213-1232.
Published online August 4, 2025
DOI: https://doi.org/10.3350/cmh.2025.0724
Intermediate-stage hepatocellular carcinoma (HCC) encompasses a diverse patient population that requires individualized treatment strategies and a multidisciplinary approach. Recent advancements in systemic therapy have expanded the therapeutic options for intermediate-stage HCC, allowing for combination strategies such as systemic therapy with transarterial chemoembolization (TACE) and upfront systemic therapy for individuals deemed unsuitable for TACE. Additionally, the ongoing development of treatment modalities for intermediate-stage HCC has improved the potential for curative conversion and tumor downstaging. Nevertheless, consensus on the optimal management of intermediate-stage HCC remains limited. Thus, the primary aim of this study was to develop a set of consensus guidelines for the management of intermediate-stage HCC. To address this gap, the Taiwan Liver Cancer Association (TLCA) established a working group to develop a multidisciplinary strategy for managing intermediate-stage HCC. Here, we present eight consensus statements formulated by this expert panel, which outline criteria for TACE unsuitability, treatment recommendations based on TACE eligibility, and considerations for various modalities, including conventional TACE, drug-eluting bead TACE, and transarterial radioembolization, as well as the appropriate timing for initiating systemic therapy to enable curative conversion and downstaging. These statements provide specific, evidence-based recommendations for clinicians, addressing treatment pathways based on TACE eligibility and other key considerations for intermediate-stage HCC management. The development of this consensus guideline is intended to aid clinicians in selecting the most appropriate treatment pathway for intermediate-stage HCC, support personalized treatment planning, and ultimately enhance the feasibility of achieving curative conversion.
  • 5,657 View
  • 394 Download
  • 1 Web of Science

Letter to the Editor

Molecular stratification of hepatocellular carcinoma by metabolic-signaling pathways guides precision immunotherapy and TACE therapy
Binghua Li, Yanchao Xu, Yican Zhu, Yukun Zhang, Zijie Wu, Tianci Luo, Laizhu Zhang, Weiwei Hu, Decai Yu
Clin Mol Hepatol 2026;32(1):e16-e20.
Published online May 8, 2025
DOI: https://doi.org/10.3350/cmh.2025.0344

Citations

Citations to this article as recorded by  Crossref logo
  • The survival prognosis after adjuvant transcatheter arterial chemoembolization in primary liver cancer: Aretrospective study
    Zhangjun Chen, Chang Lin, Jie Zhang
    Current Problems in Surgery.2025; : 101811.     CrossRef
  • S100A9 promotes resistance to anti-PD-1 immunotherapy in hepatocellular carcinoma by degrading PARP1 and activating the STAT3/PD-L1 pathway
    Xianwei Zhou, Chu Qiao, Xuehui Chu, Yajing Yang, Haoran Man, Jingxin Liu, Yunzheng Li, Zhu Xu, Huan Li, Xiaodong Shan, Zaowu Lian, Yanjun Lu, Weihong Wang, Decai Yu, Xitai Sun, Binghua Li
    Cellular Oncology.2025; 48(5): 1433.     CrossRef
  • 3,976 View
  • 137 Download
  • Crossref

Editorial

Correspondence

Hepatic neoplasm

Correspondence to editorial on “Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma”
Weifeng Zeng, Furong Liu, Yachong Liu, Zhanguo Zhang
Clin Mol Hepatol 2025;31(2):e197-e199.
Published online February 5, 2025
DOI: https://doi.org/10.3350/cmh.2025.0085
  • 5,972 View
  • 35 Download

Editorial

Hepatic neoplasm

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to editorial on “Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma”
    Weifeng Zeng, Furong Liu, Yachong Liu, Zhanguo Zhang
    Clinical and Molecular Hepatology.2025; 31(2): e197.     CrossRef
  • 5,872 View
  • 55 Download
  • 1 Web of Science
  • Crossref

Original Article

Hepatic neoplasm

Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma
Weifeng Zeng, Furong Liu, Yachong Liu, Ze Zhang, Haofan Hu, Shangwu Ning, Hongwei Zhang, Xiaoping Chen, Zhibin Liao, Zhanguo Zhang
Clin Mol Hepatol 2025;31(2):489-508.
Published online December 30, 2024
DOI: https://doi.org/10.3350/cmh.2024.0934
Background/Aims
Transmembrane 4 L six family member 1 (TM4SF1) is highly expressed and contributes to the progression of various malignancies. However, how it modulates hepatocellular carcinoma (HCC) progression and senescence remains to be elucidated.
Methods
TM4SF1 expression in HCC samples was evaluated using immunohistochemistry and flow cytometry. Cellular senescence was assessed through SA-β-gal activity assays and Western blot analysis. TM4SF1-related protein interactions were investigated using immunoprecipitation-mass spectrometry, co-immunoprecipitation, bimolecular fluorescence complementation, and immunofluorescence. Tumor-infiltrating immune cells were analyzed by flow cytometry. The HCC mouse model was established via hydrodynamic tail vein injection.
Results
TM4SF1 was highly expressed in human HCC samples and murine models. Knockdown of TM4SF1 suppressed HCC proliferation both in vitro and in vivo, inducing non-secretory senescence through upregulation of p16 and p21. TM4SF1 enhanced the interaction between AKT1 and PDPK1, thereby promoting AKT phosphorylation, which subsequently downregulated p16 and p21. Meanwhile, TM4SF1-mediated AKT phosphorylation enhanced PD-L1 expression while reducing major histocompatibility complex class I level on tumor cells, leading to impaired cytotoxic function of CD8+ T cells and an increased proportion of exhausted CD8+ T cells. In clinical HCC samples, elevated TM4SF1 expression was associated with resistance to anti-PD-1 immunotherapy. Targeting TM4SF1 via adeno-associated virus induced tumor senescence, reduced tumor burden and synergistically enhanced the efficacy of anti-PD-1 therapy.
Conclusions
Our results revealed that TM4SF1 regulated tumor cell senescence and immune evasion through the AKT pathway, highlighting its potential as a therapeutic target in HCC, particularly in combination with first-line immunotherapy.

Citations

Citations to this article as recorded by  Crossref logo
  • Regulation of cellular senescence in tumor progression and therapeutic targeting: mechanisms and pathways
    Bowei Liu, Zhigang Peng, Hao Zhang, Nan Zhang, Zaoqu Liu, Zhiwei Xia, Shaorong Huang, Peng Luo, Quan Cheng
    Molecular Cancer.2025;[Epub]     CrossRef
  • TM4SF1 - A new immune target for treatment of hepatocellular carcinoma: Editorial on “Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma”
    Chen Rui Yuan, Terence Kin Wah Lee
    Clinical and Molecular Hepatology.2025; 31(2): 646.     CrossRef
  • Targeting TM4SF1 to overcome immunotherapy resistance in hepatocellular carcinoma: Editorial on “Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma”
    Valerie Chew
    Clinical and Molecular Hepatology.2025; 31(2): 642.     CrossRef
  • Correspondence to editorial on “Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma”
    Weifeng Zeng, Furong Liu, Yachong Liu, Zhanguo Zhang
    Clinical and Molecular Hepatology.2025; 31(2): e197.     CrossRef
  • Tetraspan(in)-mediated immune regulation in hepatocellular carcinoma: Editorial on “Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma”
    Seo Hee Jin, Dong Joo Kim, Jung Weon Lee
    Clinical and Molecular Hepatology.2025; 31(2): 650.     CrossRef
  • Differential Infiltration of T-Cell Populations in Tumor and Liver Tissues Predicts Recurrence-Free Survival in Surgically Resected Hepatocellular Carcinoma
    Eun Ji Jang, Ho Joong Choi, Young Kyoung You, Deok Hwa Seo, Mi Hyun Kwon, Keungmo Yang, Jaejun Lee, Jeong Won Jang, Seung Kew Yoon, Ji Won Han, Pil Soo Sung
    Cancers.2025; 17(9): 1548.     CrossRef
  • Immunoregulatory mechanisms in the aging microenvironment: Targeting the senescence-associated secretory phenotype for cancer immunotherapy
    Haojun Wang, Yang Yu, Runze Li, Huiru Zhang, Zhe-sheng Chen, Changgang Sun, Jing Zhuang
    Acta Pharmaceutica Sinica B.2025; 15(9): 4476.     CrossRef
  • Targeting tumor-associated macrophages to overcome immune checkpoint inhibitor resistance in hepatocellular carcinoma
    Fen Liu, Xianying Li, Yiming Zhang, Shan Ge, Zhan Shi, Qingbin Liu, Shulong Jiang
    Journal of Experimental & Clinical Cancer Research.2025;[Epub]     CrossRef
  • The role of PD‑1/PD‑L1 axis in liver diseases
    Zijian Zeng, Shuanglan Chen, Qun Niu, Haijian Dong, Yuanqian Yao, Kaixin Wang, Xueqing Gong, Hui Li
    Clinical and Experimental Medicine.2025;[Epub]     CrossRef
  • 9,864 View
  • 431 Download
  • 8 Web of Science
  • Crossref

Reply to Correspondence

Hepatic neoplasm

  • 4,504 View
  • 49 Download

Correspondences

Hepatic neoplasm

Correspondence to editorial 2 on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: insights from the IMbrave150 trial”
Sun Young Yim, Sung Hwan Lee, Ji Hoon Kim, Sunyoung S Lee, Ahmed O Kaseb, Ju-Seog Lee
Clin Mol Hepatol 2025;31(1):e84-e86.
Published online October 7, 2024
DOI: https://doi.org/10.3350/cmh.2024.0830
  • 4,789 View
  • 47 Download

Hepatic neoplasm

Correspondence to editorial 1 on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: insights from the IMbrave150 Trial”
Sung Hwan Lee, Sun Young Yim, Ji Hoon Kim, Sunyoung S. Lee, Ahmed O. Kaseb, Ju-Seog Lee
Clin Mol Hepatol 2025;31(1):e81-e83.
Published online October 7, 2024
DOI: https://doi.org/10.3350/cmh.2024.0829

Citations

Citations to this article as recorded by  Crossref logo
  • Reply to correspondence on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: Insights from the IMbrave150 trial”
    Hiroaki Kanzaki, Yujin Hoshida
    Clinical and Molecular Hepatology.2025; 31(1): e121.     CrossRef
  • 5,024 View
  • 45 Download
  • Crossref

Hepatic neoplasm

Correspondence to letter to the editor on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: Insights from the IMbrave150 trial”
Sung Hwan Lee, Sun Young Yim, Ji Hoon Kim, Sunyoung S Lee, Ahmed O Kaseb, Peng Wei, Ju-Seog Lee
Clin Mol Hepatol 2025;31(1):e110-e112.
Published online October 2, 2024
DOI: https://doi.org/10.3350/cmh.2024.0828
  • 4,792 View
  • 57 Download

Letter to the Editor

Hepatic neoplasm

Comprehensive analysis of transcriptomic biomarkers for predicting response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma
Binghua Li, Jingyuan Wen, Zhu Xu, Peng Yan, Bing Han, Decai Yu
Clin Mol Hepatol 2025;31(1):e31-e34.
Published online September 20, 2024
DOI: https://doi.org/10.3350/cmh.2024.0628

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to letter to the editor on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: Insights from the IMbrave150 trial”
    Sung Hwan Lee, Sun Young Yim, Ji Hoon Kim, Sunyoung S Lee, Ahmed O Kaseb, Peng Wei, Ju-Seog Lee
    Clinical and Molecular Hepatology.2025; 31(1): e110.     CrossRef
  • S100A9 promotes resistance to anti-PD-1 immunotherapy in hepatocellular carcinoma by degrading PARP1 and activating the STAT3/PD-L1 pathway
    Xianwei Zhou, Chu Qiao, Xuehui Chu, Yajing Yang, Haoran Man, Jingxin Liu, Yunzheng Li, Zhu Xu, Huan Li, Xiaodong Shan, Zaowu Lian, Yanjun Lu, Weihong Wang, Decai Yu, Xitai Sun, Binghua Li
    Cellular Oncology.2025; 48(5): 1433.     CrossRef
  • Comment on “Clinical outcomes and histologic findings of patients with hepatocellular carcinoma with durable partial response or durable stable disease after receiving atezolizumab plus bevacizumab”
    Binghua Li, Qiang Wang, Weiwei Hu, Huan Li, Peng Yan, Yajuan Cao, Decai Yu
    iLIVER.2024; 3(4): 100130.     CrossRef
  • 5,877 View
  • 129 Download
  • 2 Web of Science
  • Crossref

Editorial

Hepatic neoplasm

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to editorial 1 on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: insights from the IMbrave150 Trial”
    Sung Hwan Lee, Sun Young Yim, Ji Hoon Kim, Sunyoung S. Lee, Ahmed O. Kaseb, Ju-Seog Lee
    Clinical and Molecular Hepatology.2025; 31(1): e81.     CrossRef
  • Advances and challenges in immunotherapy and molecular imaging for hepatocellular carcinoma
    Tu Haibin
    Discover Oncology.2025;[Epub]     CrossRef
  • 6,242 View
  • 99 Download
  • 1 Web of Science
  • Crossref

Original Articles

Hepatic neoplasm

Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: Insights from the IMbrave150 trial
Sun Young Yim, Sung Hwan Lee, Seung-Woo Baek, Bohwa Sohn, Yun Seong Jeong, Sang-Hee Kang, Kena Park, Hyewon Park, Sunyoung S. Lee, Ahmed O. Kaseb, Young Nyun Park, Sun-Hee Leem, Michael A. Curran, Ji Hoon Kim, Ju-Seog Lee
Clin Mol Hepatol 2024;30(4):807-823.
Published online July 23, 2024
DOI: https://doi.org/10.3350/cmh.2024.0333
Background/Aims
Combination immunotherapy, exemplified by atezolizumab plus bevacizumab, has become the standard of care for inoperable hepatocellular carcinoma (HCC). However, the lack of predictive biomarkers and limited understanding of response mechanisms remain a challenge.
Methods
Using data from the IMbrave150plus cohort, we applied an immune signature score (ISS) predictor to stratify HCC patients treated with atezolizumab plus bevacizumab or with sorafenib alone into potential high and low response groups. By applying multiple statistical approaches including a Bayesian covariate prediction algorithm, we refined the signature to 10 key genes (ISS10) for clinical use while maintaining similar predictive power to the full model. We further validated ISS10 in an independent HCC cohort treated with nivolumab plus ipilimumab.
Results
The study identified a significant association between the ISS and treatment response. Among patients classified as high responders, those treated with the atezolizumab plus bevacizumab combination exhibited improved overall and progression-free survival as well as better
objective
response rate compared to those treated with sorafenib. We also observed a significant correlation between ISS10 and response to nivolumab plus ipilimumab treatment. Analysis of immune cell subpopulations revealed distinct characteristics associated with ISS subtypes. In particular, the ISS10 high subtype displayed a more favorable immune environment with higher proportions of antitumor macrophages and activated T-cells, potentially explaining its better response.
Conclusions
Our study suggests that ISS and ISS10 are promising predictive biomarkers for enhanced therapeutic outcomes in HCC patients undergoing combination immunotherapy. These markers are crucial for refining patient stratification and personalized treatment approaches to advance the effectiveness of standard-of-care regimens.

Citations

Citations to this article as recorded by  Crossref logo
  • Targeting TIME in advanced hepatocellular carcinoma: Mechanisms of drug resistance and treatment strategies
    Xinyi Ye, Xizhu Fang, Fangfang Li, Dan Jin
    Critical Reviews in Oncology/Hematology.2025; 211: 104735.     CrossRef
  • Differential Infiltration of T-Cell Populations in Tumor and Liver Tissues Predicts Recurrence-Free Survival in Surgically Resected Hepatocellular Carcinoma
    Eun Ji Jang, Ho Joong Choi, Young Kyoung You, Deok Hwa Seo, Mi Hyun Kwon, Keungmo Yang, Jaejun Lee, Jeong Won Jang, Seung Kew Yoon, Ji Won Han, Pil Soo Sung
    Cancers.2025; 17(9): 1548.     CrossRef
  • Advances in cancer immunotherapy: historical perspectives, current developments, and future directions
    Meiyin Zhang, Chaojun Liu, Jing Tu, Min Tang, Milad Ashrafizadeh, Noushin Nabavi, Gautam Sethi, Peiqing Zhao, Shijian Liu
    Molecular Cancer.2025;[Epub]     CrossRef
  • Management and Outcomes of Adverse Events Following Immune Checkpoint Inhibitor Treatment in Patients with Hepatocellular Carcinoma
    Soon Kyu Lee, Bo Hyun Kim
    Journal of Digestive Cancer Research.2025; 13(1): 65.     CrossRef
  • Managing hepatocellular carcinoma recurrence after liver transplantation: emerging role of immune checkpoint inhibitors
    Mohammad Saeid Rezaee-Zavareh, Soo Young Hwang, Naomy Kim, Hasmik Adetyan, Nguyen H. Tran, Ju Dong Yang
    Discover Oncology.2025;[Epub]     CrossRef
  • Hepatic Metabolic Signature and Its Association with the Response to Immunotherapy in Hepatocellular Carcinoma
    Hyewon Park, Sowon Park, Kena Park, Sun Young Yim, Ju-Seog Lee, Sung Hwan Lee
    ImmunoTargets and Therapy.2025; Volume 14: 787.     CrossRef
  • Development and validation of a risk prediction model for patients with hepatocellular carcinoma receiving atezolizumab–bevacizumab
    Heechul Nam, Dong Yun Kim, Do Young Kim, Ji Hoon Kim, Chang Wook Kim, Jaejun Lee, Keungmo Yang, Ji Won Han, Pil Soo Sung, Seung Kew Yoon, Hee Sun Cho, Hyun Yang, Si Hyun Bae, Soon Kyu Lee, Jung Hyun Kwon, Soon Woo Nam, Ahlim Lee, Do Seon Song, U Im Chang,
    Hepatology.2025;[Epub]     CrossRef
  • Bulk and Single-Cell Transcriptomes Reveal Exhausted Signature in Prognosis of Hepatocellular Carcinoma
    Ruixin Chun, Haisen Ni, Ziyi Zhao, Chunlong Zhang
    Genes.2025; 16(9): 1034.     CrossRef
  • Efficacy and Safety of Different Doses of Bevacizumab Combined with Atezolizumab in Unresectable Hepatocellular Carcinoma
    Shaobo Zhang, Jiabei Wang, Zebin Zhu, Peng Ji, Yanli Wang, Kun Cheng, Björn Nashan, Lianxin Liu, Shugeng Zhang
    Journal of Hepatocellular Carcinoma.2025; Volume 12: 2007.     CrossRef
  • Ultrasounic-radiomics models for predicting the response to Atezolizumab plus Bevacizumab in patients with unresectable hepatocellular carcinoma
    Yiran Li, Zonghan Liu, Yi Qian, Kang Wang, Yijun Gu, Yan Chen, Haozheng Jiang, Shuqun Cheng, Dong Jiang, Xinjun Lu
    PLOS One.2025; 20(10): e0334099.     CrossRef
  • Prognostic Significance of Glypican-3 Expression in Hepatocellular Carcinoma Treated with Atezolizumab-Bevacizumab
    Ji Hoon Kim, Ji Won Han, Hee Sun Cho, Jeong Won Jang, Kwon Yong Tak, Pil Soo Sung
    Cancers.2025; 17(24): 3967.     CrossRef
  • An Early Increase in IL-10 and TNF-α Levels Following Atezolizumab Plus Bevacizumab Treatment Predicts Survival in Advanced Hepatocellular Carcinoma Patients: A Prospective Cohort Study
    Soon Kyu Lee, Soon Woo Nam, Ji Won Han, Jung Hyun Kwon
    Cancers.2024; 16(20): 3543.     CrossRef
  • From biomarker discovery to combined therapies: Advancing hepatocellular carcinoma treatment strategies
    Mo-Wei Kong, Yang Yu, Ying Wan, Yu Gao, Chun-Xiang Zhang
    World Journal of Gastrointestinal Oncology.2024; 16(11): 4518.     CrossRef
  • 11,966 View
  • 393 Download
  • 19 Web of Science
  • Crossref

Hepatic neoplasm

Genetically-modified, redirected T cells target hepatitis B surface antigen-positive hepatocytes and hepatocellular carcinoma lesions in a clinical setting
Xueshuai Wan, Karin Wisskirchen, Tao Jin, Lu Yang, Xiaorui Wang, Xiang’an Wu, Fang Liu, Yu Wu, Christy Ma, Yong Pang, Qi Li, Ke Zhang, Ulrike Protzer, Shunda Du
Clin Mol Hepatol 2024;30(4):735-755.
Published online May 29, 2024
DOI: https://doi.org/10.3350/cmh.2024.0058
Background/Aims
Hepatitis B virus (HBV)-DNA integration in HBV-related hepatocellular carcinoma (HBV-HCC) can be targeted by HBV-specific T cells. SCG101 is an autologous, HBV-specific T-cell product expressing a T-cell receptor (TCR) after lentiviral transduction recognizing the envelope-derived peptide (S20-28) on HLA-A2. We here validated its safety and efficacy preclinically and applied it to an HBV-related HCC patient (NCT05339321).
Methods
Good Manufacturing Practice-grade manufactured cells were assessed for off-target reactivity and functionality against hepatoma cells. Subsequently, a patient with advanced HBV-HCC (Child-Pugh class A, Barcelona Clinic Liver Cancer stage B, Eastern Cooperative Oncology Group performance status 0, hepatitis B e antigen-, serum hepatitis B surface antigen [HBsAg]+, HBsAg+ hepatocytes 10%) received 7.9×107 cells/kg after lymphodepletion. Safety, T-cell persistence, and antiviral and antitumor efficacy were evaluated.
Results
SCG101, produced at high numbers in a closed-bag system, showed HBV-specific functionality against HBV-HCC cells in vitro and in vivo. Clinically, treatment was well tolerated, and all adverse events, including transient hepatic damage, were reversible. On day 3, ALT levels increased to 1,404 U/L, and concurrently, serum HBsAg started decreasing by 3.84 log10 and remained <1 IU/mL for over six months. HBsAg-expressing hepatocytes in liver biopsies were undetectable after 73 days. The patient achieved a partial response according to modified RECIST with a >70% reduction in target lesion size. Transferred T cells expanded, developed a stem cell-like memory phenotype, and were still detectable after six months in the patient’s blood.
Conclusions
SCG101 T-cell therapy showed encouraging efficacy and safety in preclinical models and in a patient with primary HBV-HCC and concomitant chronic hepatitis B with the capability to eliminate HBsAg+ cells and achieve sustained tumor control after single dosing.

Citations

Citations to this article as recorded by  Crossref logo
  • Clinical results of an HBV-specific T-cell receptor-T-cell therapy (SCG101) in patients with HBV-related hepatocellular carcinoma treated in an investigator-initiated, interventional trial
    Xiang'an Wu, Dongmei Quan, Wei Li, Karin Wisskirchen, Wei Wu, Yuhong Zhou, Yun-Peng Liu, Xueshuai Wan, Xiaorui Wang, Xuxu Zhang, Lu Yang, Mengyao Zheng, Ke Zhang, Ulrike Protzer, Shunda Du, Xiujuan Qu
    Gut.2026; 75(1): 147.     CrossRef
  • Reply to correspondence on “Genetically-modified, redirected T cells target hepatitis B surface antigen-positive hepatocytes and hepatocellular carcinoma lesions in a clinical setting”
    Antonio Bertoletti, Anthony T Tan
    Clinical and Molecular Hepatology.2025; 31(1): e113.     CrossRef
  • Correspondence to editorial on “Genetically-modified, redirected T cells target hepatitis B surface antigen-positive hepatocytes and hepatocellular carcinoma lesions in a clinical setting”
    Shunda Du, Karin Wisskirchen, Ke Zhang, Ulrike Protzer
    Clinical and Molecular Hepatology.2025; 31(1): e44.     CrossRef
  • T lymphocyte-based immune response and therapy in hepatocellular carcinoma: focus on TILs and CAR-T cells
    Thikra Majid Muhammed, Saade Abdalkareem Jasim, Ahmed Hussein Zwamel, Safia Obaidur Rab, Suhas Ballal, Abhayveer Singh, Anima Nanda, Subhashree Ray, Ahmed Hjazi, Hatif Abdulrazaq Yasin
    Naunyn-Schmiedeberg's Archives of Pharmacology.2025; 398(8): 10007.     CrossRef
  • Hepatitis B: Neue therapeutische Ansätze für eine funktionelle Heilung
    Markus Cornberg, Ulrike Protzer
    Deutsches Ärzteblatt Online.2025;[Epub]     CrossRef
  • Exploration of the role of immune cells and cell therapy in hepatocellular carcinoma
    Tao Zhang, Cong Ren, Zhanyu Yang, Ning Zhang, Haowen Tang
    Frontiers in Immunology.2025;[Epub]     CrossRef
  • Viral oncogenesis in cancer: from mechanisms to therapeutics
    Qing Xiao, Yi Liu, Tingting Li, Chaoyu Wang, Sanxiu He, Liuyue Zhai, Zailin Yang, Xiaomei Zhang, Yongzhong Wu, Yao Liu
    Signal Transduction and Targeted Therapy.2025;[Epub]     CrossRef
  • Unlocking T‐Cell Plasticity in the Tumor Microenvironment: Implications for Cancer Progression and Therapeutic Strategies
    Xiao‐Hong Ding, Xue‐Pei Li, Fenfang Chen, Han Wang, Yi‐Zhou Jiang
    MedComm – Oncology.2025;[Epub]     CrossRef
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    Zhiqi Guan, Guiqi Zhu, Weiren Liu, Yinghong Shi
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Letter to the Editor

Steatotic liver disease

Changing from NAFLD to MASLD: Similar prognosis of patients with HCC under atezolizumab/bevacizumab treatment between NAFLD and MASLD
Hiroyuki Suzuki, Shigeo Shimose, Hideki Iwamoto, Takashi Niizeki, Takumi Kawaguchi
Clin Mol Hepatol 2024;30(2):263-265.
Published online January 18, 2024
DOI: https://doi.org/10.3350/cmh.2023.0557

Citations

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Review

Hepatic neoplasm

Recent advances in the management of hepatocellular carcinoma
Kamya Sankar, Jun Gong, Arsen Osipov, Steven A. Miles, Kambiz Kosari, Nicholas N. Nissen, Andrew E. Hendifar, Ekaterina K. Koltsova, Ju Dong Yang
Clin Mol Hepatol 2024;30(1):1-15.
Published online July 21, 2023
DOI: https://doi.org/10.3350/cmh.2023.0125
Liver cancer remains a challenge of global health, being the 4th leading cause of cancer death worldwide. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and is usually precipitated by chronic viral infections (hepatitis B and C), non-alcoholic steatohepatitis, heavy alcohol use, and other factors which may lead to chronic inflammation and cirrhosis of the liver. There have been significant advances in the systemic treatment options for HCC over the past decades, with several approvals of both immune checkpoint inhibitors and tyrosine kinase inhibitors in patients with preserved liver function. These advances have led to improvement in survival outcomes, with expected survival of greater than 18 months, in those with sensitive tumors, adequate liver function, and those functionally fit to receive sequential therapies. Several ongoing and promising trials are now evaluating combinational strategies with novel systemic agents and combinations of systemic therapy with locoregional therapy. In view of these trials, further advances in the treatment of HCC are foreseen in the near future.

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Editorial

Hepatic neoplasm

Management of hepatocellular carcinoma in China: Seeking common grounds while reserving differences
Tian Yang, Ming-Da Wang, Xin-Fei Xu, Chao Li, Han Wu, Feng Shen
Clin Mol Hepatol 2023;29(2):342-344.
Published online March 16, 2023
DOI: https://doi.org/10.3350/cmh.2023.0106

Citations

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Snapshot

Hepatic neoplasm

Systemic therapy in advanced hepatocellular carcinoma
Joseph C. Ahn, Nguyen H. Tran, Ju Dong Yang
Clin Mol Hepatol 2023;29(2):516-519.
Published online February 20, 2023
DOI: https://doi.org/10.3350/cmh.2023.0051

Citations

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  • Disparities in Immunotherapy Use Prior to First-Line Approval for Metastatic Hepatocellular Carcinoma in the United States
    Manav Shah, Abdullah Khalid, Oliver Standring, Neda Amini, Lyudmyla Demyan, Shruti Koti, Emma Gazzara, Grace Wu, Nandan Vithlani, Danielle DePeralta, Sepideh Gholami, Matthew Weiss
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    Min Kyung Park, Yoon Jun Kim
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Reviews

Hepatic neoplasm

Clinical practice guidelines and real-life practice on hepatocellular carcinoma: A the Hong Kong perspective
Rex Wan-Hin Hui, Lung-Yi Mak, Tan-To Cheung, Victor Ho-Fun Lee, Wai-Kay Seto, Man-Fung Yuen
Clin Mol Hepatol 2023;29(2):217-229.
Published online December 28, 2022
DOI: https://doi.org/10.3350/cmh.2022.0399
Hepatocellular carcinoma (HCC) is a major public health burden in Hong Kong, and chronic hepatitis B is the most common HCC etiology in our region. With the high case load, extensive local expertise on HCC has been accumulated. This article summarized local guidelines and real-life practice on HCC management in Hong Kong. For HCC surveillance, liver ultrasound and serum alpha-fetoprotein for periodic screening is recommended in viral hepatitis or cirrhotic patients, and this is adhered to in clinical practice. HCC diagnosis is not covered in local guidelines, yet our practice is in-line with regional guidelines, where diagnosis is usually achieved by cross-sectional imaging and without the need for histology. Our guidelines recommend using the Hong Kong Liver Cancer Staging for pre-treatment staging, yet we routinely use other widely-adopted systems such as the Barcelona Clinic Liver Cancer Staging and the Tumor-Node-Metastasis Staging as well. Our local guidelines have provided clear treatment algorithms for the whole range of HCC therapies, including resection, ablation, transplant, transarterial chemoembolization, transarterial radioembolization, stereotactic body radiation therapy, targeted therapy, and immunotherapy. Real-life treatment choices are largely in line with the guidelines, although treatment protocols are individualized, and availability of specific therapies can vary between centers. Overall, HCC guidelines in Hong Kong are tailored based on local expertise and our unique patient population. The guidelines are up-to-date and provide practical pathways to assist our routine practice. Regular updates of local guidelines are warranted to account for the rapidly evolving paradigm of HCC management.

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Crosstalk between tumor-associated macrophages and neighboring cells in hepatocellular carcinoma
Pil Soo Sung
Clin Mol Hepatol 2022;28(3):333-350.
Published online October 19, 2021
DOI: https://doi.org/10.3350/cmh.2021.0308
The tumor microenvironment generally shows a substantial immunosuppressive activity in hepatocellular carcinoma (HCC), accounting for the suboptimal efficacy of immune-based treatments for this difficult-to-treat cancer. The crosstalk between tumor cells and various cell types in the tumor microenvironment is strongly related to HCC progression and treatment resistance. Monocytes are recruited to the HCC tumor microenvironment by various factors and become tumor-associated macrophages (TAMs) with distinct phenotypes. TAMs often contribute to weakened tumor-specific immune responses and a more aggressive phenotype of malignancy. Recent single-cell RNA-sequencing data have demonstrated the central roles of specific TAMs in tumorigenesis and treatment resistance by their interactions with various cell populations in the HCC tumor microenvironment. This review focuses on the roles of TAMs and the crosstalk between TAMs and neighboring cell types in the HCC tumor microenvironment.

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Original Article

Hepatic neoplasm

Radiation-induced abscopal effect and its enhancement by programmed cell death 1 blockade in the hepatocellular carcinoma: A murine model study
Gyu Sang Yoo, Won-Gyun Ahn, Shin-Yeong Kim, Wonseok Kang, Changhoon Choi, Hee Chul Park
Clin Mol Hepatol 2021;27(1):144-156.
Published online December 7, 2020
DOI: https://doi.org/10.3350/cmh.2020.0095
Background/Aims
The abscopal effect, a rare phenomenon induced by radiation, can be reinforced by immunotherapy. Although radiation therapy and immunotherapy are increasingly being utilized for the treatment of hepatocellular carcinoma (HCC), whether immunotherapy could boost the abscopal effect remains unclear. In this study, we aimed to elucidate the immunological mechanisms underlying the abscopal effect induced by the combination of irradiation and immunotherapy in a murine HCC model.
Methods
A syngeneic HCC mouse model was established by transplanting murine Hepa 1–6 HCC cells into both hind legs of immunocompetent C57BL/6 mice. The tumors on the right hind legs were irradiated, and abscopal effects were observed in the non-irradiated tumors on the left hind leg with or without the coadministration of anti-programmed cell death 1 (PD-1) antibodies. Flow cytometric analyses were performed to analyze the distributions of immune cells infiltrating both irradiated and non-irradiated tumors and the tumor-draining lymph nodes (TDLNs).
Results
Administration of 16 Gy in two fractions more effectively inhibited the growth of both irradiated and nonirradiated tumors with higher tumor infiltration of cytotoxic T cells than 8 Gy did in a single fraction. The higher dose also increased activated dendritic cells in TDLNs, which had higher expression of the programmed cell death ligand 1. Coadministration of anti-PD-1 antibodies significantly enhanced the abscopal effect and increased infiltration of activated cytotoxic T cells in both irradiated and non-irradiated tumors.
Conclusions
Our findings show that adding anti-PD-1 therapy to radiation enhanced the abscopal effect in a syngeneic murine model of HCC.

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Editorial

Hepatic neoplasm

Long-term prognosis and management of hepatocellular carcinoma after curative treatment
Naoshi Nishida
Clin Mol Hepatol 2020;26(4):480-483.
Published online September 21, 2020
DOI: https://doi.org/10.3350/cmh.2020.0208

Citations

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Review

Hepatic neoplasm

Treatment options after sorafenib failure in patients with hepatocellular carcinoma
Imane El Dika, Ghassan K. Abou-Alfa
Clin Mol Hepatol 2017;23(4):273-279.
Published online November 20, 2017
DOI: https://doi.org/10.3350/cmh.2017.0108
Second line therapy after failure of sorafenib continues to be under study. Prognosis of hepatocellular carcinoma is measured in months, with median overall survival reaching 10.7 months with sorafenib. Because of the modest net benefit sorafenib has contributed, and rising incidence of hepatocellular carcinoma in the world, continued efforts are ongoing to look for efficient upfront, second line, or combination therapies. Herein we review the most relevant to date published literature on treatment options beyond sorafenib, reported studies, ongoing investigational efforts, and possibilities for future studies in advanced hepatocellular carcinoma.

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