Hepatology international · 2026
Immune-checkpoint inhibitors for advanced hepatocellular carcinoma in Child-Turcotte-Pugh-B cirrhosis: a liver-centric approach to outcomes beyond tumor progression.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Agrawal Dhiraj, Jothimani Dinesh, Bhoori Sherrie, Reddy Guru N, Saigal Sanjiv, Rela Mohamed, Mazzaferro Vincenzo
Аннотация
BACKGROUND: Immune checkpoint inhibitors (ICIs) have revolutionized advanced hepatocellular carcinoma (HCC) outcomes in Child-Turcotte-Pugh A (CTP-A) cirrhosis. However, 30-40% of real-world advanced HCC cases involve CTP-B cirrhosis, yet are excluded from pivotal trials, representing a substantial unmet need.
METHODS: Immunotherapy for CTP-B HCC has not yet been comprehensively reviewed. This narrative review summarizes the latest evidence on ICIs in CTP-B HCC through January 2026, evaluating ICI efficacy, safety, and patient selection algorithms across CTP-B subclasses. We present a balanced perspective on pre-ICI portal hypertension screening/prophylaxis, decompensation triggers/recompensation strategies, immune-mediated hepatitis differentiation, locoregional therapy sequencing, and transplant-bridging risks with ICI in the CTP-B patient population.
RESULTS: ICIs demonstrate modest efficacy with tolerable safety in well-selected CTP-B7-B8 HCC patients, but require liver-centric considerations to mitigate the risk of decompensation. We propose liver-centric trial endpoints and a multidisciplinary (oncology-hepatology-transplant) framework to improve outcomes in this hard-to-treat population, and to include CTP-B HCC patients in clinical trials to address evidence gaps.
CONCLUSIONS: This review provides comprehensive guidance on ICIs for CTP-B HCC, identifying key clinical practices and knowledge gaps to inform real-world use and future research.
METHODS: Immunotherapy for CTP-B HCC has not yet been comprehensively reviewed. This narrative review summarizes the latest evidence on ICIs in CTP-B HCC through January 2026, evaluating ICI efficacy, safety, and patient selection algorithms across CTP-B subclasses. We present a balanced perspective on pre-ICI portal hypertension screening/prophylaxis, decompensation triggers/recompensation strategies, immune-mediated hepatitis differentiation, locoregional therapy sequencing, and transplant-bridging risks with ICI in the CTP-B patient population.
RESULTS: ICIs demonstrate modest efficacy with tolerable safety in well-selected CTP-B7-B8 HCC patients, but require liver-centric considerations to mitigate the risk of decompensation. We propose liver-centric trial endpoints and a multidisciplinary (oncology-hepatology-transplant) framework to improve outcomes in this hard-to-treat population, and to include CTP-B HCC patients in clinical trials to address evidence gaps.
CONCLUSIONS: This review provides comprehensive guidance on ICIs for CTP-B HCC, identifying key clinical practices and knowledge gaps to inform real-world use and future research.