Immunotherapy for liver cancer

Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer. This works to kill cancer cells and stop cancer cells from growing and spreading.

Immunotherapy is sometimes used to treat liver cancer. If you have immunotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

Immunotherapy may be the only treatment you have or it may be used along with other treatments. You may have immunotherapy to:

• shrink advanced or metastatic liver cancer tumours
• control symptoms of liver cancer

The immune system normally stops itself from attacking healthy cells in the body by using specific proteins called checkpoints. Checkpoints slow down or stop an immune system response. Some liver cancer cells can use these checkpoints to hide and avoid being attacked by the immune system.

Immune checkpoint inhibitors work by blocking the checkpoint proteins so immune system cells (called T-cells) attack and kill the cancer cells. Immune checkpoint inhibitors are monoclonal antibodies, which are substances that find and attach to a specific antigen on a cancer cell.

Pembrolizumab (Keytruda) is an immune checkpoint inhibitor that targets the PD-1 checkpoint protein. You may be offered pembrolizumab if you have already had treatment with a targeted therapy drug called sorafenib (Nexavar) or are unable to take sorafenib.

Atezolizumab (Tecentriq, Tecentriq SQ) is an immune checkpoint inhibitor that targets the PD-L1 checkpoint protein. You may be offered atezolizumab with bevacizumab (Avastin) if you are unable to have surgery or if you have metastatic liver cancer and have not yet had any other treatment. This drug can be given into the vein (intravenously) or under the skin (subcutaneously).

Tremelimumab (Imjudo) is an immune checkpoint inhibitor that targets the CTLA-4 checkpoint protein. You may be offered tremelimumab with durvalumab (Imfinzi) if you are unable to have surgery for hepatocellular carcinoma and have not yet had any other treatment.

Immunotherapy drugs for liver cancer may not be covered by all provincial or territorial drug plans. Your doctor or healthcare team will discuss access to these drugs with you and if you may benefit from this treatment.

Side effects of immunotherapy will depend mainly on the type of drug or drug combination, the dose, how it's given and your overall health. Tell your healthcare team if you have side effects that you think might be from immunotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Common possible side effects of immunotherapy for liver cancer include:

• fatigue
• loss of appetite
• nausea
• diarrhea
• skin problems, including rash and itching

Find out more about immunotherapy. To make the decisions that are right for you, ask your healthcare team questions about immunotherapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.