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When immunotherapy meets liver transplantation for hepatocellular carcinoma:A bumpy but promising road

摘要Liver transplantation(LT)is a highly curative therapy for patients with hepatocellular carcinoma(HCC).However,due to the shortage of donor livers and rapid progression of HCC,a majority of patients are dropped out from the waitlist.Recently,immunotherapy has shown great promise in the treatment of advanced HCC.However,the use of immunotherapy is limited in LT mainly due to the potentially increasing risk of graft rejection.One of the main challenges for researchers is the protection of donor graft from an immunotherapy-boosted immune response mounted by the host.Besides,the safety,availability,and costs of immunotherapy are other challenges that need to be addressed.Here,we reviewed the literature involving patients who received immunotherapy prior to transplant to avoid waitlist dropouts and following transplantation to prevent the progression of tumor recurrence and metastasis.Statistically,the incidence of rejection was 25.0%pre-transplant and 18.5%post-transplant.Based on the review of these clinical studies,we can conclude that conducting clinical trials on the safety and efficacy of currently available immunotherapy drugs and identifying novel immunotherapy targets through extensive research may be promising for patients who do not meet the selection criteria for LT and who experience post-transplant recurrence.To date,the clinical experience on the use of immunotherapy before or after LT comes from individual case studies.Although some of the reported results are promising,they are not sufficient to support the standardized use of immunotherapy in clinical practice.

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作者 Yufeng Gu [1] Shengjun Xu [2] Zhengxin Wang [3] Jiayin Yang [4] Shusen Zheng [5] Qiang Wei [2] Zhikun Liu [2] Xiao Xu [6] 学术成果认领
作者单位 The Fourth School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Hepatobiliary and Pancreatic Surgery,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Institute of Organ Transplantation,Zhejiang University,Hangzhou 310003,China [1] Department of Hepatobiliary and Pancreatic Surgery,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province,Hangzhou 310006,China [2] Department of General Surgery,Huashan Hospital,Fudan University,Shanghai 200040,China [3] Department of Liver Surgery,Liver Transplantation Center,West China Hospital of Sichuan University,Chengdu 610044,China [4] Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Hepatobiliary and Pancreatic Surgery,Shulan(Hangzhou)Hospital,Hangzhou 311112,China [5] The Fourth School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Hepatobiliary and Pancreatic Surgery,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Institute of Organ Transplantation,Zhejiang University,Hangzhou 310003,China;Westlake Laboratory of Life Sciences and Biomedicine,Hangzhou 310024,China [6]
栏目名称 Review Article
DOI 10.21147/j.issn.1000-9604.2023.02.02
发布时间 2023-06-01
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中国癌症研究(英文版)

中国癌症研究(英文版)

2023年35卷2期

92-107页

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