Immunotherapy for Liver Cancer

Immunotherapy is the use of medicines that help a person’s own immune system find and destroy cancer cells. It can be used to treat some people with liver cancer.

Immune checkpoint inhibitors

An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses “checkpoints” – proteins on immune cells that need to be turned on (or off) to start an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. But newer drugs that target these checkpoints hold a lot of promise as cancer treatments.

Pembrolizumab (Keytruda) and nivolumab (Opdivo) are drugs that target PD-1, a protein on immune system cells called T cells that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.

These drugs can be used in people with liver cancer who have previously been treated with the targeted drug sorafenib (Nexavar).

These drugs are given as an intravenous (IV) infusion, typically every 2, 3 ,or 4 weeks.

Possible side effects

Side effects of these drugs can include:

  • Feeling tired or weak
  • Fever
  • Cough
  • Nausea
  • Itching
  • Skin rash
  • Loss of appetite
  • Muscle or joint pain
  • Constipation or diarrhea

Other, more serious side effects occur less often:

Infusion reactions: Some people might have an infusion reaction while getting these drugs. This is like an allergic reaction, and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. It’s important to tell your doctor or nurse right away if you have any of these symptoms while getting these drugs.

Autoimmune reactions: These drugs work by basically removing one of the safeguards on the body’s immune system. Sometimes the immune system starts attacking other parts of the body, which can cause serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, skin, or other organs.

It’s very important to report any new side effects to your health care team promptly. If serious side effects do occur, treatment may need to be stopped and you may get high doses of corticosteroids to suppress your immune system.

More information about immunotherapy

To learn more about how drugs that work on the immune system are used to treat cancer, see Cancer Immunotherapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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National Cancer Institute. Physician Data Query (PDQ). Adult Primary Liver Cancer Treatment. Accessed at https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq on March 11, 2019.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers. V.1.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf on March 11, 2019.

Stuart KE. Systemic treatment for advanced hepatocellular carcinoma. UpToDate website. https://www.uptodate.com/contents/systemic-treatment-for-advanced-hepatocellular-carcinoma. Updated January 16, 2019. Accessed March 11, 2019.

Zhu AX, Finn RS, Edeline J, Cattan S et al. Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): a non-randomised, open-label phase 2 trial. Lancet Oncol. 2018 Jul;19(7):940-952. doi: 10.1016/S1470-2045(18)30351-6. Epub 2018 Jun 3.

 

Last Medical Review: April 1, 2019 Last Revised: April 1, 2019

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