While chemotherapy works directly on tumors to kill cancer cells, immunotherapy works by “revving up” a patient’s own immune system to attack the cancer. It is another relatively new treatment that strives to improve the immune system’s ability to identify and destroy cancer cells. Immunotherapy has been used in many different types of cancer, including liver cancer.
There are several different types of immunotherapies that are being developed for many different diseases. These include:
- Checkpoint inhibitors – drugs that block proteins that stop the immune system from recognizing and attacking the cancer cells
- Adoptive cell transfer therapy – a treatment that engineers a patient’s own immune cells to better recognize the cancer, grows them in a lab, and reinserts them in the body to attack the cancer. One type of adoptive cell therapy that has already made strong progress in certain types of blood cancers is CAR-T (chimeric antigen receptor T cell) therapy.
- Monoclonal antibodies (MABs) – immune system proteins created in the lab that are designed to bind to specific targets on cancer cells. While some MABs are considered “targeted therapy”, some can be used to mark cancer cells so that they will be better seen and destroyed by the immune system.
- Treatment vaccines – vaccines which cause a person’s immune system to attack cancer cells.
- Immune system modulators – naturally occurring proteins that enhance the body’s immune response against cancer.
Immunotherapies used as treatment for FLC
Of those five types of immunotherapy, three are currently being used to treat FLC, including checkpoint inhibitors, monoclonal antibodies and immune system modulators. In each of these immunotherapy categories, patient treatment with at least one drug is already underway.
Combination therapies including immunotherapy
Across many cancers, there has been a lot of research conducted investigating the benefit of combining immunotherapy treatments (especially checkpoint inhibitors) with other therapies, including chemotherapy, targeted therapy and radiation therapy. It is thought that the breakdown of tumor cells by other drugs and localized treatments could help immune cells recognize a cancer as foreign, and therefore improve the effectiveness of the immunotherapy. Alternatively, the additional treatments could potentially drive additional immune cells to penetrate the tumor and therefore enhance the impact of the immunotherapy treatment.
Notable immunotherapy combination treatments under investigation for FLC include:
- Nivolumab, plus 5-fluorouracil (5-FU) and interferon alpha-2b. Many fibrolamellar patients have already been prescribed this “triple therapy” at some institutions. See the clinical trials page for more information about a clinical trial that is trying to understand the interactions of this combination and the value of sequencing the drugs.
- Ipilimumab plus nivolumab (approved in 2020 for the treatment of HCC).
- Atezolizumab plus bevacizumab (approved in 2020 for the treatment of HCC).
- Nivolumab plus lenvatinib.
Please note: The Fibrolamellar Cancer Foundation does not provide medical advice or recommend any specific organizations or services. We provide website users with information to help them better understand their health conditions and current approaches to the diagnosis and treatment of FLC. Always seek the advice of your physician or other qualified healthcare providers.