Intratumoral bicarbonate functions as an adjuvant to potentiate PD-1 blockade in hepatocellular carcinoma
Injecting sodium bicarbonate directly into liver tumors boosts immunotherapy response rates to 93%, offering a simple, low-cost way to improve treatment for advanced hepatocellular carcinoma.
Intratumoral injection of sodium bicarbonate disrupts the acidic tumor microenvironment in HCC, triggering cGAS-STING-mediated immune activation and synergizing with anti-PD-1 therapy Tislelizumab to achieve a 93.3% objective response rate in 30 patients. If confirmed in larger trials, this cheap, accessible intervention could substantially improve immunotherapy outcomes in advanced HCC.
What the study was
- Study design
- Prospective open-label clinical study (ChiCTR2100053537) with murine preclinical support
- Population
- Advanced and intermediate stage HCC patients receiving Tislelizumab + intratumoral 5% sodium bicarbonate
- Sample size
- 30
- Category
- Treatment Innovation
- Maturity
- Exploratory
- Journal
- Oncogene
Why it surfaced
Extraordinary ORR (93.3%) with CR 53.3% in advanced HCC using a radically novel and low-cost adjuvant (intratumoral sodium bicarbonate). Mechanism (cGAS-STING via mitochondrial alkalization) is mechanistically coherent and supported by murine data. Critical caveat: n=30 single-institution open-label study — requires large RCT confirmation before clinical adoption.
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