免疫检查点抑制剂（ICIs）如程序性细胞死亡-1（PD-1）/程序性细胞死亡配体1（PD-L1）抑制剂已在包括原发性肝癌（PLC）（如肝细胞癌和胆管癌）等几种重要癌症中显示出显著的疗效。然而，只有部分PLC患者能够获益，因此联合治疗和通过下一代测序或免疫组化检测的生物标志物分类非常重要。在此，我们简要总结了基于ICI的治疗，并将这些进化中的治疗方法分为三个阶段的免疫治疗Mark（Mk.）1.0, 2.0和3.0。我们阐述了ICI单药疗法（Mk.1.0）的重要性，提供了与传统策略联合应用的方法（Mk.2.0），以及额外的局部治疗（Mk.3.0）来实现更长的生存时间甚至达到“无疾病证据”状态。我们还强调了通过ICI治疗的晚期PLC患者的生物标志物和预后因素的重要性。应进行多学科团队管理，紧密合作，以管理患者的不良事件和顺序治疗建议。 © 2023 作者发表于德格鲁伊特（De Gruyter），柏林/波士顿。

Immune checkpoint inhibitors (ICIs) like programmed cell death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor have shown considerable efficacy in several important cancers including primary liver cancer (PLC) like hepatocellular carcinoma and cholangiocarcinoma. However, only some patients with PLC will benefit, so combination therapy and biomarker classification detected by next-generation sequencing or immunohistochemistry are very important. Herein, we briefly summarize ICI-based therapies and stratify these evolving therapies for advanced PLC into three stages of immunotherapies Mark (Mk.) 1.0, 2.0, and 3.0. We illustrated the significance of ICI monotherapy (Mk. 1.0), offering combinational approaches with traditional strategies (Mk. 2.0) and additional locoregional therapy (Mk. 3.0) to achieve longer survival and even meet the "No Evidence of Disease" status. We also highlight the importance of biomarkers and prognostic factors for patients with advanced PLC treated with ICI-based therapies. Multidisciplinary team management should be investigated and collaborated closely to manage adverse events and sequential therapy suggestions for patients.© 2023 the author(s), published by De Gruyter, Berlin/Boston.