Insights into an immunotherapeutic approach to combat multidrug resistance in hepatocellular carcinoma

Aswathy R. Devan, Ayana R. Kumar, Bhagyalakshmi Nair, Nikhil Ponnoor Anto, Amitha Muraleedharan, Bijo Mathew, Hoon Kim, Lekshmi R. Nath

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Hepatocellular carcinoma (HCC) has emerged as one of the most lethal cancers worldwide because of its high refractoriness and multi-drug resistance to existing chemotherapies, which leads to poor patient survival. Novel pharmacological strategies to tackle HCC are based on oral multi-kinase inhibitors like sorafenib; however, the clinical use of the drug is restricted due to the limited survival rate and significant side effects, suggesting the existence of a primary or/and acquired drug-resistance mechanism. Because of this hurdle, HCC patients are forced through incomplete therapy. Although multiple approaches have been employed in parallel to overcome multidrug resistance (MDR), the results are varying with insignificant outcomes. In the past decade, cancer immunotherapy has emerged as a breakthrough approach and has played a critical role in HCC treatment. The liver is the main immune organ of the lymphatic system. Researchers utilize immunotherapy because immune evasion is considered a major reason for rapid HCC progression. Moreover, the immune response can be augmented and sustained, thus preventing cancer relapse over the post-treatment period. In this review, we provide detailed insights into the immunotherapeutic approaches to combat MDR by focusing on HCC, together with challenges in clinical translation.

Original languageEnglish
Article number656
Issue number7
StatePublished - 1 Jul 2021


  • Hepatocellular carcinoma
  • Immunotherapy
  • Multidrug resistance

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmaceutical Science
  • Drug Discovery


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