Immunotherapy and Cirrhosis: Expanding Child–Pugh Boundaries in Liver Cancer

Immunotherapy has historically been restricted to patients with hepatocellular carcinoma with well-preserved liver function, based upon safety and efficacy data established in clinical trial populations. Although an immunosuppressive microenvironment coupled with comorbid cirrhosis may contribute to poorer outcomes, a subset of patients with worse degrees of liver function achieves significant clinical benefit from combination immunotherapy. See related article by Lee et al., p. 4323.