原发性肝癌是发病率和死亡率较高的恶性肿瘤之一，其系统治疗长期面临瓶颈。免疫检查点抑制剂改变了晚期肝癌的系统治疗格局，然而晚期肝癌的药物免疫治疗的关键临床研究仍面临诸多挑战，如独特的免疫相关不良反应、滞后的疗效评价标准、免疫微环境的异质性和耐药。在优化新型药物免疫治疗、精准药物免疫治疗的同时，须将目光投向更具颠覆性的前沿领域，如个体化新抗原疫苗、细胞治疗等新模式。总结了药物免疫治疗肝癌的成就和局限，解构肝癌免疫耐药的独特生物学本质，探索在新技术驱动下肝癌药物免疫治疗的精准路径。

Primary liver cancer is one of the malignant tumors with high incidence and mortality rates, and its systemic treatment has long faced bottlenecks. Immune checkpoint inhibitors have transformed the landscape of systemic therapy for advanced liver cancer, yet key clinical studies on drug immunotherapy for advanced liver cancer still encounter numerous challenges, such as unique immune-related adverse reactions, lagging efficacy evaluation criteria, immune microenvironment heterogeneity, and drug resistance. With the optimization of new drug immunotherapy and precision drug immunotherapy, it is necessary to focus on more disruptive cutting-edge fields, such as personalized new antigen vaccines, cell therapy, and other new models. This article summarizes the achievements and limitations of drug immunotherapy for liver cancer, deconstructs the unique biological nature of immune resistance in liver cancer, and explores the precise path of drug immunotherapy for liver cancer driven by new technologies.

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