Neoadjuvant systemic therapy for hepatocellular carcinoma: challenges and opportunities—a narrative review

Neoadjuvant therapy involving immunotherapy, particularly immune checkpoint inhibitors, seems to exhibit the most promising characteristics of preventing recurrence and improving long-term survival of HCC patients following curative hepatectomy or LT, especially when combined with anti-angiogenic therapies and locoregional therapy. Further research is needed to identify suitable candidates, predictive biomarkers, optimal regimens for neoadjuvant therapy, and ideal timing for surgery.