Immunopathology of Hepatobiliary Tumors and Immunotherapy of Liver Cancers

Hepatobiliary tumors are a diverse group of tumors that arise from the hepatobiliary tract including the liver, gallbladder, and bile tract. Hepatocellular cancer is the most common type of liver cancer and is usually related to chronic infection with hepatitis virus. Gallbladder cancer is less common in clinical practice, but the prognosis of the patients is very poor. Cholangiocarcinoma, cancer of the bile tract, is complex due to its anatomic segmentation. The mainstay treatment modality for these tumors includes surgery, liver transplantation, interventional therapy, targeted therapy, and chemotherapy. However, for the majority of patients with advanced cancer, the treatment option is limited and the efficacy is not satisfactory. Therefore, the development of novel therapies is highly required. Recently, the role of immunopathology from cancer microenvironment in the process of carcinogenesis and progression has been unveiled. Cytokines and lymphokines such as interleukin-6 and lymphotoxin, together with immune cells such as tumor-associated macrophages, play an important role in this process. Disruption in normal immune regulatory mechanisms provides additional therapeutic targets for cancer. Various immunotherapy strategies are proposed for hepatobiliary cancers including cancer vaccine, adoptive transfer of immune cells, and antibody therapy. This chapter seeks to discuss recent advances in immunopathology of hepatobiliary cancer, with emphasis on immunotherapy in liver cancers at both preclinical and clinical levels.