Research Article
Research Progress and Real-World Research Perspectives of Immunity-Based Combination Regimens for Hepatocellular Carcinoma in the Chinese Population
Issue:
Volume 15, Issue 5, October 2026
Pages:
69-74
Received:
9 September 2026
Accepted:
4 October 2026
Published:
10 November 2026
DOI:
10.11648/j.cmr.20261505.11
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Abstract: China bears the world's heaviest disease burden of hepatocellular carcinoma (HCC), with hepatitis B virus (HBV) infection as the predominant aetiology. Most patients are diagnosed at intermediate-to-advanced stages, achieving only limited benefit with conventional systemic therapy. Combination therapies centring on programmed death-1 (PD-1)/programmed death ligand-1(PD-L1) immune checkpoint inhibitors have reshaped the diagnostic and therapeutic landscape of HCC, establishing four mainstream modalities: immunotherapy combined with anti-angiogenic targeted agents, dual immunotherapy, immunotherapy plus locoregional therapy, and perioperative targeted-immunotherapy with comprehensive management. While phase III clinical trials and updated domestic guidelines have confirmed that these combination regimens significantly improve objective response rates and prolong overall survival, the stringent eligibility criteria of randomised controlled trials (RCTs) limit their generalisability. These criteria make it difficult to reflect real-world treatment outcomes in Chinese patients, who frequently present with coexisting liver cirrhosis, hepatic impairment, and multiple comorbidities—resulting in a notable gap in stratified, real-world evidence generated from local populations. This review systematically summarises the mechanisms of action, clinical evidence, and evolving guideline recommendations for immune-based combinations in Chinese patients with HCC, and analyses current bottlenecks in clinical research. Based on the design of a national multicentre real-world registry study, we further discuss the value of real-world research for optimising individualised immunotherapy for HCC in China, so as to provide evidence-based references for clinical practice and scientific exploration.
Abstract: China bears the world's heaviest disease burden of hepatocellular carcinoma (HCC), with hepatitis B virus (HBV) infection as the predominant aetiology. Most patients are diagnosed at intermediate-to-advanced stages, achieving only limited benefit with conventional systemic therapy. Combination therapies centring on programmed death-1 (PD-1)/program...
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,
Hua Yunqi
