肝细胞癌（HCC）是一种常见的原发性肝癌，约占病例的85%。由于诊断常在中晚期确诊，因此系统治疗成为首选治疗方式。尽管索拉非尼在过去十年一直是晚期HCC的确立标准治疗，系统治疗的疗效仍然不尽如人意，突显了新的治疗模式的需求。免疫疗法的最新突破已经显示出在HCC治疗中的潜力，特别是免疫检查点抑制剂（ICIs）。然而，对ICIs的反应率目前仅限于约15%-20%的HCC患者。最近，ICIs在“热性”肿瘤中展示出更好的疗效，突显了迫切需要制定更有效的方法将“冷性”肿瘤转化为“热性”肿瘤，从而增强ICIs的治疗潜力。本综述提供了一份对影响HCC免疫疗法疗效的因素的最新总结，鉴定了潜在的联合疗法，可能提高对ICIs的患者反应率，并提供了正在进行的以ICIs为基础的联合疗法的临床试验概述。版权©2023 Yu, Li, Ren, Cheng, Wang, Ma, Yong, Chen, Wang和Goh。

Hepatocellular carcinoma (HCC) is a prevalent primary liver cancer, representing approximately 85% of cases. The diagnosis is often made in the middle and late stages, necessitating systemic treatment as the primary therapeutic option. Despite sorafenib being the established standard of care for advanced HCC in the past decade, the efficacy of systemic therapy remains unsatisfactory, highlighting the need for novel treatment modalities. Recent breakthroughs in immunotherapy have shown promise in HCC treatment, particularly with immune checkpoint inhibitors (ICIs). However, the response rate to ICIs is currently limited to approximately 15%-20% of HCC patients. Recently, ICIs demonstrated greater efficacy in "hot" tumors, highlighting the urgency to devise more effective approaches to transform "cold" tumors into "hot" tumors, thereby enhancing the therapeutic potential of ICIs. This review presented an updated summary of the factors influencing the effectiveness of immunotherapy in HCC treatment, identified potential combination therapies that may improve patient response rates to ICIs, and offered an overview of ongoing clinical trials focusing on ICI-based combination therapy.Copyright © 2023 Yu, Li, Ren, Cheng, Wang, Ma, Yong, Chen, Wang and Goh.