# Differences in Tumor‐Infiltrating Lymphocyte Counts in the Peritumoral Area in Patients Undergoing Hepatic Resection After Lenvatinib and Atezolizumab Plus Bevacizumab Therapy for Hepatocellular Carcinoma

## TL;DR

This study compares immune cell levels in liver cancer patients treated with two different therapies before surgery, finding higher immune cell counts with one treatment.

## Contribution

The study is the first to evaluate immune status in the peritumoral area after lenvatinib or atezolizumab plus bevacizumab therapy for HCC.

## Key findings

- TIL counts were significantly higher after ATZ/BEV therapy compared to LEN therapy.
- CD3+ and CD8+ TIL counts were also significantly higher in the ATZ/BEV group.
- These findings suggest ATZ/BEV may enhance immune cell infiltration in the peritumoral area.

## Abstract

With advances in systemic therapy, the number of patients with hepatocellular carcinoma (HCC) who can undergo hepatic resection has increased in recent years, but there are no reports evaluating the immune status in the peritumoral area.

We enrolled 14 patients who underwent hepatic resection after lenvatinib (LEN, n = 7) or atezolizumab plus bevacizumab (ATZ/BEV, n = 5) therapy. Tumor‐infiltrating lymphocytes (TILs), including CD3+ and CD8+ TILs, in the peritumoral area were evaluated by hematoxylin and eosin staining and immunohistochemistry.

The median TIL counts after LEN and ATZ/BEV therapy were 32 and 92 cells/0.237 mm2, respectively (p = 0.0044). The median CD3+ TIL counts after LEN and ATZ/BEV therapy were 26 and 71 cells/0.237 mm2, respectively (p = 0.0057). The median CD8+ TIL counts after LEN and ATZ/BEV therapy were 14 and 42 cells/0.237 mm2, respectively (p = 0.0044).

TIL counts, including those of CD3+ and CD8+ TILs, in the peritumoral area were significantly higher after ATZ/BEV than after LEN therapy.