Dendritic Cell Served as Salvage Therapy for Advanced Hepatocellular Carcinoma Resistant to Tyrosine Kinase or Immune Checkpoint Inhibitors

Background/objectives: Current treatments for advanced hepatocellular carcinoma (HCC) are tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICI). When HCC is resistant to TKI or ICI, subsequent available treatments are limited. Dendritic cells (DC) can activate antigen-specific cytotoxic T-cells and may be employed as a subsequent treatment when HCC is resistant to TKI or ICI treatments. Methods: Fifty advanced HCC patients with resistance to ICI or TKI treatment were invited to have autologous DC therapy. DCs were propagated from peripheral blood monocytes and pulsed with tumor lysate. All the patients received ≥3 courses of DC intravenously. For the outcome analysis, 17 patients who were resistant to TKI or other traditional treatments were grouped into A, and 33 patients who were resistant to ICI treatment were grouped into B. Results: For group A patients, the median (interquartile) progression-free and overall survivals were 6 (3–16.3) and 19 (8–24) months, respectively. The 1-, 2- and 3-year overall survivals after DC therapy were 58.2%, 21.8%, and 14.6%, respectively. For group B patients, the median (interquartile) progression-free and overall survivals were 5.0 (4–8) and 9 (5–14.5) months, respectively. The 1-, 2- and 3-year overall survivals after DC therapy were 27.6%, 8.6% and 4.3%, respectively. Taking together 50 patients, the objective response rate was 6.0% and disease control rate was 72.0%. Only three patients (6.0%) had grade I-II hepatitis. Conclusions: DC therapy is a safe treatment for advanced HCC patients. DC can serve as a subsequent therapy to extend the patients’ lives when TKI or ICI treatments are ineffective as advanced HCC treatments.