Exosomal PD-L1 in hepatocellular carcinoma: Immune evasion mechanisms, diagnostic value, and strategies for therapeutic targeting - 23/04/26

Abstract |
Hepatocellular carcinoma (HCC) employs multiple layers of immune evasion, among which exosomal programmed death-ligand 1 (exoPD-L1) has emerged as a key mediator and clinically relevant biomarker. Through vesicular packaging and systemic dissemination, exoPD-L1 reinforces an immunosuppressive milieu beyond the spatial constraints of membrane-bound PD-L1, thereby attenuating cytotoxic lymphocyte activity and facilitating tumor progression. Increasing evidence indicates that circulating exoPD-L1 constitutes a minimally invasive, dynamic biomarker that captures real-time immunological states, with potential utility in predicting responsiveness to immune checkpoint inhibitors, monitoring therapeutic trajectories, and refining patient stratification. Moreover, the biogenesis and functional deployment of exoPD-L1 reveal actionable vulnerabilities—ranging from neutralization and inhibition of vesicular loading to disruption of secretion pathways—that may augment current immunotherapeutic strategies in HCC. Nonetheless, methodological inconsistencies, heterogeneous assay platforms, and limited prospective validation currently constrain clinical translation. This review synthesizes mechanistic insights, evaluates liquid biopsy applications, and outlines emerging therapeutic interventions targeting the exoPD-L1 axis, highlighting priorities for future investigation.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Exosomal PD-L1 mediates immune escape and systemic suppression in HCC. |
• | Blood exosomal PD-L1 supports diagnosis, prognosis, and dynamic monitoring. |
• | Integrating tissue PD-L1 IHC with blood exosomal PD-L1 improves stratification. |
• | Neutralization, reduced output, and clearance require safety-aware translation. |
Keywords : Hepatocellular carcinoma, Exosomes, PD-L1, Immune evasion, Immunotherapy, Biomarker
Plan
Vol 198
Article 119268- mai 2026 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?
