Management of Hepatocellular Carcinoma Recurrence After Liver Transplantation

Valdivieso, A.; Bustamante, Javier; Gastaca, Mikel; Uriarte, J.G.; Ventoso, A.; Ruíz, P.; Fernández, José R.; Pijoan, I.; Testillano, M.; Suárez, María; Montejo, Miguel; Urbina, J. Ortiz de

doi:10.1016/j.transproceed.2010.02.014

Cited by 97 publications

(102 citation statements)

References 22 publications

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“…In 2010, the Bilbao group reported 2 patients with recurrent HCC; they were managed solely with a combination of everolimus and sorafenib and were alive at 18.5 (without recurrence) and 10 months (with recurrence) 6 ; the Bilbao group has used this combination as its standard protocol for proven HCC recurrence since 2007.…”

Section: Role Of Systemic Therapymentioning

confidence: 99%

Treatment of recurrent hepatocellular carcinoma after liver transplantation

et al. 2011

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Section: Role Of Systemic Therapymentioning

confidence: 99%

Treatment of recurrent hepatocellular carcinoma after liver transplantation

et al. 2011

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“…Progression-free survival and overall survival were not presented but sorafenib was tolerable, although the majority of patients required dose reduction. In 1 small series, 5 patients received sorafenib + everolimus after HCC reoccurrence after OLT, with a median survival of 18.8 months [19]. In this study there were no significant postoperative, immunologic, or hematologic complications and no significant pharmacodynamic interactions were observed with everolimus.…”

Section: Discussionmentioning

confidence: 69%

Safety and Feasibility of Using Sorafenib in Recurrent Hepatocellular Carcinoma after Orthotopic Liver Transplantation

Kim¹,

El-Gazzaz²,

Tan³

et al. 2010

Oncology

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Background and Aim: The majority of patients who undergo orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) have a very good prognosis if the tumor is within the Milan criteria. However, 10–15% of patients will have reoccurrence after OLT. Currently, sorafenib is available for advanced HCC. The safety and efficacy of sorafenib in this population has not been reported. Methods: We retrospectively looked at 54 patients who received sorafenib for advanced HCC. Out of 54 patients, we analyzed 9 who received sorafenib after OLT for HCC reoccurrence at Cleveland Clinic. Result: The median age at the time treatment with sorafenib was initiated was 59 years (range 46–77). Two patients received prior local therapy. Most of the toxicity was expected side effects from sorafenib except in 1 patient who developed hematological toxicity. Six patients required dose reduction secondary to toxicity. There were no unexpected complications from interaction with immunosuppressive medication. One patient achieved complete radiographic remission. Median survival from the start of sorafenib had not been reached at the time of writing; however, the 4-month survival rate is currently estimated to be 84 ± 15%, and 1 patient with lung reoccurrence has been treated for almost 18 months thus far. Conclusion: Sorafenib can be used in patients with recurrent HCC after liver transplantation with tolerable toxicity; however, dose adjustment may be required. A larger prospective study is necessary to determine the efficacy of sorafenib in this group of patients.

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“…Regarding everolimus, there are some data to suggest that it can protect against HCC recurrence after transplant as well as to be of use in the management of patients with recurrent HCC after transplant (70,71). Data from phase 1 and 2 studies showed a stabilization of HCC progression with everolimus (72,73).…”

Section: Mammalian Target Of Rapamycin Inhibitors (Mtor)mentioning

confidence: 99%