Inflammatory microenvironment and immunotherapy in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is considered a classic inflammation-associated tumor that usually originates from chronic hepatitis, where an intense and chronic inflammatory response leads to the accumulation of mutations and eventually carcinogenesis under conditions of persistent liver injury. In recent years, immunotherapy for HCC has continued to evolve, as the liver is naturally filled with a large variety of immune cells, making hepatocellular carcinoma a more complex inflammatory microenvironment unlike other tumors. With a better understanding of the specific inflammatory microenvironment of HCC, there is an opportunity to try new therapeutic strategies for HCC immunotherapy. In this paper, we review the immunotherapy of primary liver cancer in terms of the correlation between ICI drugs, ACT therapy and the inflammatory microenvironment of HCC, summarize and discuss the progress and difficulties of immunotherapy of liver cancer, and provide more scientific guidance for immunotherapy of primary liver cancer.