Combating inconsistent evaluation of intra-tumor immune status by a novel transcriptomic signature in hepatocellular carcinoma

Dear Editor, Harnessing the power of the immune system via immune checkpoint inhibition has revolutionized the treatment paradigm of many malignancies,including hepatocellular carcinoma(HCC).1 Despite encouraging efficacy seen with the immune checkpoint blockade(ICB)agents in a subset of patients with HCC,however,there remain a large number of HCC patients experience ICB resistance and failed to derive durable benefit from these agents,which underscores the need of patient selection for ICB treatment.1 Previous study showed that HCC tumors could be stratified into two classes:inflamed and non-inflamed classes.2 In contrast to non-inflamed class,inflamed class exhibits higher immune infiltration and cytolytic activity,and is associated with enhanced responsiveness to ICB therapy.2,3 Accordingly,deter-mining the immune status of HCC tumors has important clinical significance,which can be leveraged to identify patients who are most likely to benefit from ICB therapy.Recently,a study by Montironi et al.reports a 20-gene signature that can be used to divide HCC tumors into these two classes.4 This signature was developed based on transcriptomic data from single-region samples,and has been demonstrated to have a favorable performance for immune status prediction.4