Immunotherapy is an emerging treatment option for liver cancer. It involves taking medications that help your immune system recognize and destroy cancer cells.

Liver cancer is the fourteenth most diagnosed cancer in the United States. People who consume large amounts of alcohol for many years and people with chronic hepatitis infection are at the highest risk of being diagnosed.

Immunotherapy is a type of cancer treatment that involves stimulating your immune system to destroy cancer cells. It may help reduce side effects and improve survival compared to traditional liver cancer treatments.

Research on how to best use immunotherapy to treat liver cancer is still rapidly expanding. It’s currently sometimes used to treat cancer spread throughout the liver or cancer spread to distant body parts.

Read on to learn about how immunotherapy is used to manage liver cancer and what to expect during your treatment.

Immunotherapy is a rapidly evolving type of treatment for liver cancer. It involves taking medications that help your immune system recognize and attack cancer cells.

As of May 2023, 55 clinical trials examining the use of immunotherapy for treating liver cancer are active or recruiting in the United States.

Immunotherapy is currently used as a first-line or second-line treatment to help extend the life of people with cancer spread throughout their liver or people with metastatic liver cancer. Metastatic liver cancer is when the cancer has spread to distant parts of your body.

The most common class of immunotherapy drugs used to treat liver cancer are called immune checkpoint inhibitors.

How immune checkpoint inhibitors work

Cells in your immune system called T cells can identify and attack cancer cells, but some cancers are able to avoid detection.

The surface of your T cells contains “checkpoint” proteins that can turn on and off to keep your T cells from accidentally attacking healthy cells. Proteins on the surface of cancer cells can bind to checkpoint proteins. This binding turns off your T cells and keeps them from destroying the cancer cells.

Immune checkpoint inhibitors block the binding of proteins on cancer cells with checkpoint proteins and keep your T cells turned on.

Types of immunotherapy drugs used to treat liver cancer

Combinations of drugs that doctors use to treat liver cancer include:

  • atezolizumab (Tecentriq) with the targeted therapy drug bevacizumab (Avastin) as the first-line therapy for metastatic liver cancer or cancer that can’t be cured with surgery
  • durvalumab (Imfinzi) with tremelimumab (Imjudo) as the first-line treatment for liver cancer that can’t be treated surgically
  • pembrolizumab (Keytruda) as a second-line therapy to treat advanced liver cancer
  • nivolumab (Opdivo), usually with ipilimumab (Yervoy), to treat advanced liver cancer that didn’t respond to previous treatment

Medical professionals administer immunotherapy as an IV infusion. The frequency that you need to receive immunotherapy drugs depends on which drugs you receive.

Here’s the typical timeline:

MedicationsTime frame
atezolizumab (Tecentriq) and bevacizumab (Avastin)Every 2, 3, or 4 weeks
durvalumab (Imfinzi) and tremelimumab (Imjudo)Every 2, 3, or 4 weeks
pembrolizumab (Keytruda)Every 2, 3, 4, or 6 weeks
nivolumab (Opdivo)Every 2, 3, 4, or 6 weeks

You may feel mild discomfort when you receive the infusion. Some people experience side effects shortly after their treatment. It’s essential to alert your doctor of any side effects you experience.

According to the American Cancer Society, potential side effects of checkpoint inhibitors include:

Rarer but potentially more serious side effects can include infusion reactions or autoimmune reactions.

Infusion reactions are hypersensitivities that develop during or shortly after your treatment. They require immediate medical attention. Signs of an infusion reaction can include:

An autoimmune reaction is when your immune system attacks healthy cells. It can cause serious or even life threatening complications such as hormonal or lung problems.

Serious autoimmune reactions seem to occur most often with ipilimumab (Yervoy).

Researchers are continuing to examine how to best use immunotherapy to treat liver cancer. It can potentially increase survival rates while decreasing side effects caused by other cancer treatments.

In a 2020 clinical trial, the overall response rate for people with advanced liver cancer who received nivolumab (Optivo) was 20%. This means that 20% of people who received the drug had either a complete or partial response.

In a 2018 clinical trial, 17% of people with advanced liver cancer treated with pembrolizumab (Keytruda) and previously treated with sorafenib (Nexavar) had a complete or partial response to treatment.

Other treatments for liver cancer include:

  • Active surveillance: Your doctor may recommend active surveillance for tumors smaller than 1 centimeter (0.4 inches). Active surveillance involves watching how the tumor changes without administrating a specific treatment.
  • Surgery: A type of surgery called partial hepatectomy is often performed. This surgery involves removing part of your liver.
  • Liver transplant: Removing the entire liver and receiving a liver transplant is an option if a transplant is available and cancer is contained in the liver.
  • Ablation therapy: Ablation therapy is a minimally invasive procedure to destroy liver tissue. Tissue may be destroyed in many ways, such as with:
    • high-energy radio waves
    • ethanol injections
    • electricity
    • cold
  • Embolization therapy: Embolization therapy may be an option if your cancer is contained in your liver. Embolization therapy uses drugs to block blood flow to cancer cells.
  • Targeted therapy: Targeted therapy is a drug therapy that specifically targets cancer cells.
  • Radiation therapy: Radiation therapy uses high-energy waves to destroy cancer cells.

Learn more about liver cancer treatment.

Immunotherapy is an emerging treatment option for liver cancer. It involves taking medications that stimulate your immune system to recognize and destroy cancer cells.

Doctors sometimes use immunotherapy as a first-line or second-line treatment for liver cancer that’s spread too far to be removed surgically or has spread to distant organs.