Stereotactic Body Radiation Therapy Combined With Immunotherapy for Patients With Hepatocellular Carcinoma‐A Review

ABSTRACT Radiotherapy has been proven to act synergistically with immunotherapy to prime the immune response against the immunosuppressive tumour microenvironment. Stereotactic body radiation therapy (SBRT) produces a greater variety of tumour‐associated antigens. This can elicit an even stronger anti‐tumour immune response, especially when combined with immune checkpoint inhibitors to prevent T cell exhaustion. This response is particularly useful in hepatocellular carcinoma patients due to a naturally immunosuppressive environment. SBRT has provided excellent local control rates in patients with hepatocellular carcinoma (HCC). Retrospective and prospective clinical trials involving advanced‐stage HCC patients support combining SBRT with immune checkpoint inhibitors. Actively recruiting phase III randomised controlled trials are currently testing this promising combination in HCC patients. This mini‐review outlines the rationale for combining the two modalities in HCC patients. Current guidelines for HCC and successes in the field using the combination treatment will also be discussed.