Aetiology of liver disease and response to immune checkpoint inhibitors: An updated meta-analysis confirms benefit in those with non-viral liver disease

Clinical outcomes for advanced hepatocellular carcinoma (HCC) have significantly improved with the introduction of immune checkpoint inhibitors (ICIs), but results from initial trials have suggested that the aetiology of liver disease may be a predictive marker of clinical benefit, and stratification based on aetiology has been recommended. The differential response has been supported by preclinical models and reinforced in the recent review.1,2 But as more clinical data emerge, the association between liver disease aetiology and response to ICI-based therapy has become less clear.