Current status of the organ replacement approach for malignancies and an overture for organ bioengineering and regenerative medicine

Transplant Oncology: An Evolving Field in Cancer Care

“…As a result, the Milan criteria has been modified by many transplant societies to determine whether other patients with HCC can be eligible for LT with an acceptable survival rate of 5 years after transplantation ( Figure 2 ). These efforts expanded the Milan criteria, which depend on the strict tumor size and number of nodules to determine an HCC patient’s eligibility for LT, to depend on overall tumor size and number of nodules as well as different tumor markers such as AFP [ 7 ]. This expansion of the criteria has polarized into the classifications of University of California San Francisco (UCSF) and beyond UCSF [ 8 ].…”

What is transplant oncology?

“…LT for intrahepatic cholangiocarcinoma (ICCA) has been contraindicated in most centers based on the poor results reported in the late 1980s and early 20 0 0s. 1,2 The main caveat with those studies was the relatively small number of patients, the combined analysis of patients with PhCCA and ICCA, and the inclusion of cirrhotic and noncirrhotic patients. Sapisochin et al 19 demonstrated in a multicenter, retrospective study conducted in Spain and validated in an international study 20 that LT for "very early" ICCA (single tumor and up to 2 cm) in cirrhotic patients achieved excellent 5-year overall survival and recurrence rates (73% and 0% in the Spanish cohort and 65% and 18% in the international cohort).…”

“…40 The true value of these "extreme" resections has yet to be defined and these procedures should only be considered for highly selected patients in a combined transplant and oncology program after an extensive, multidisciplinary discussion. 1,41…”

“…Transplant oncology is a new concept encompassing multiple disciplines of transplantation medicine and oncology designed to push the envelope of the treatment and research of hepatobiliary cancers. 1,2 Liver transplantation (LT) for hepatobiliary malignancies constitutes only a part of this concept, and all of the following form critical components of transplant oncology: application of transplantation techniques in cancer surgery to extend the limit of conventional resection and the bridge linking tumor and transplant immunology, which thereby pave the way to a novel, anticancer strategy and a platform for conducting genomic studies based on new insights on cancer immunogenomics. This mini review is designed to illustrate this new field of transplant oncology and to underscore the importance of convening all the relevant experts in transplantation medicine and oncology, including transplantation and hepatobiliary surgeons, medical and radiation oncologists, hepatologists and gastroenterologists, immunologists, etc, to maximize the care and cure of cancer patients.…”

Immunotherapy as a Neoadjuvant Therapy for a Patient with Hepatocellular Carcinoma in the Pretransplant Setting: A Case Report

“…In the last decade, the transplant oncology field has been evolving and advances in locoregional and systemic therapies including immunotherapy have provided additional options for further exploration of neoadjuvant and adjuvant strategies to improve HCC resection rates [ 6 , 7 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. We report an interesting case of a patient with HCC who developed pseudo-progression followed by an excellent response with significant downstaging after neoadjuvant treatment with atezolizumab plus bevacizumab.…”