Impact of treatment modalities on patients with recurrent hepatocellular carcinoma after liver transplantation: Preliminary experience

Yang, Zhe; Wang, Shuo; Tian, Xinyao; Xie, Qinfen; Li, Zhuang; Li, Qiyong; Chen, Cheng-Ze; Zheng, Shusen

doi:10.1016/j.hbpd.2020.06.002

Cited by 23 publications

(34 citation statements)

References 24 publications

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“…Various mTOR inhibitors (mTORi) have been developed as immunosuppressive agents including sirolimus, and everolimus, which have shown to also have anti-tumour growth effects through suppression of cellular proliferation and angiogenesis 58,59 . Multiple cohort studies demonstrated decreased risk for post-transplantation HCC recurrence and longer post-recurrence survival using mTORi compared to CNIs [60][61][62] . One retrospective study by Yang et al, 2020 showed that compared to tacrolimus-based immunosuppression, sirolimus improved OS at one and two years following post-transplant HCC recurrence (P=0.035) 62 .…”

Section: The Interplay Of Immunosuppression and Hcc Recurrencementioning

confidence: 99%

“…Multiple cohort studies demonstrated decreased risk for post-transplantation HCC recurrence and longer post-recurrence survival using mTORi compared to CNIs [60][61][62] . One retrospective study by Yang et al, 2020 showed that compared to tacrolimus-based immunosuppression, sirolimus improved OS at one and two years following post-transplant HCC recurrence (P=0.035) 62 . Contrarily, a large international multicentre randomized control trial (the SiLVER trial), investigating sirolimus-based versus mTORi-free immunosuppression in LT for HCC, demonstrated no significant difference in overall or recurrence-free survival with mTORi 63 .…”

Section: The Interplay Of Immunosuppression and Hcc Recurrencementioning

confidence: 99%

“…Sorafenib was the earliest approved of the targeted therapies with clinically proven efficacy for unresectable HCC 105 . Multiple retrospective studies show that combining sorafenib with mTORi, and treating early in the disease course following post-transplantation HCC recurrence, leads to disease stability or a complete or partial response 62,[106][107][108][109][110][111][112][113] . These studies have demonstrated a survival benefit from systemic therapy ranging from 7.5-20 months, compared to best supportive care alone 62,[106][107][108][109][110][111][112][113] .…”

Section: Systemic Therapymentioning

confidence: 99%

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The management of post-transplantation recurrence of hepatocellular carcinoma

et al. 2022

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The annual incidence of hepatocellular carcinoma (HCC) continues to rise. Over the last two decades, liver transplantation (LT) has become the preferable treatment of HCC, when feasible and strict selection criteria are met.With the rise in HCC-related liver transplantation, compounded by downstaging techniques and expansion of transplant selection criteria, a parallel increase in number of post-transplantation HCC recurrence is expected.Additionally, in the context of an immunosuppressed transplant host, recurrences may behave aggressively and more challenging to manage, resulting in poor prognosis. Despite this, no consensus or best practice guidelines for posttransplantation cancer surveillance and recurrence management for HCC currently exist. Studies with adequate population sizes and high-level evidence are lacking, and the role of systemic and locoregional therapies for graft and extrahepatic recurrences remains under debate. This review seeks to summarize the existing literature on posttransplant HCC surveillance and recurrence management. It highlights the value of early tumour detection, reevaluating the immunosuppression regimen, and staging to differentiate disseminated recurrence from intrahepatic or extrahepatic oligo-recurrence. This ultimately guides decision-making and maximizes treatment effect. Treatment recommendations specific to recurrence type are provided based on currently available locoregional and systemic therapies.

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Section: The Interplay Of Immunosuppression and Hcc Recurrencementioning

confidence: 99%

Section: The Interplay Of Immunosuppression and Hcc Recurrencementioning

confidence: 99%

Section: Systemic Therapymentioning

confidence: 99%

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The management of post-transplantation recurrence of hepatocellular carcinoma

et al. 2022

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“…Especially for Asian HCC patients, the over survival of patients in the lenvatinib group was significantly longer than that in the SOR group, which suggests that Asian HCC patients be the dominant group of patients suitable for lenvatinib treatment[ 62 ]. Yang et al [ 65 ] found that the post-LT recurrence patients in the SOR ineffective or tolerant group had significantly improved overall survival after switching to lenvatinib. Six of these patients received combined therapy of lenvatinib and RAPA after reoperation, and the overall survival was 80% at 2 years, which was significantly longer than that in the control group.…”

Section: Trends Of Combined Therapy Of Rapa and Anti-tumor Drugs In Survival Benefits Of Transplant For Hccmentioning

confidence: 99%

Trends of rapamycin in survival benefits of liver transplantation for hepatocellular carcinoma

Zhao¹,

Liu²,

Zhou³

et al. 2021

WJGS

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The proportion of liver transplantation (LT) for hepatocellular carcinoma (HCC) has kept on increasing over the past years and account for 20%-40% of all LT. Post-transplant HCC recurrence is considered the most important factor affecting the long-term survival of patients. The use of different types of immunosuppressive agents after LT is closely associated with an increased risk for HCC recurrence. The most commonly used conventional immunosuppressive drugs include the calcineurin inhibitors tacrolimus (FK506) and mammalian target of rapamycin inhibitor rapamycin (RAPA). Compared with tacrolimus, RAPA may carry an advantage in survival benefit because of its anti-tumor effects. However, no sufficient evidence to date has proven that RAPA could increase long-term recurrence-free survival and its anti-tumor mechanism of combined therapy remains incompletely clear. In this review, we will focus on recent advances in clinical application experience and basic research results of RAPA in patients undergoing LT for HCC to further guide the clinical practice.

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“…Práce z čínského Hangzhou ukázala šest pacientů, kteří byli léčeni resekcí jater a následně sorafenibem a lenvatinibem s úpravou imunosuprese na mTOR inhibitor s 2letým přežíváním 80 %. V jiné práci u pacientů pouze se systémovou léčbou sorafenib-lenvatinib byl medián přežití 19,5 měsíce [38]. Italská multicentrická studie uvádí u pacientů, kteří podstoupili resekci plicních metastáz, pravděpodobnost 5letého přežívání 43 % a medián přežívání 51 měsíců [39].…”

Section: Transplantace Jater Pro Rekurenci Hcc Po Resekci Nebo Ablaciunclassified