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

Abdelrahim, Maen; Esmail, Abdullah; Umoru, Godsfavour; Westhart, Kiersten; Abudayyeh, Ala; Saharia, Ashish; Ghobrial, Rafik M.

doi:10.3390/curroncol29060341

Cited by 32 publications

(28 citation statements)

References 27 publications

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“…We have collated data from all reported patients who received checkpoint inhibitors just before liver transplantation for HCC (Table 3). These include 4 case series [79][80][81][82] and various single case reports [83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99]. Altogether, rejection occurred in 8 out of 41 patients, in which there were 2 deaths[89,95] and 1 requiring re-transplant [81,83].…”

Section: Immune Checkpoint Inhibitorsmentioning

confidence: 99%

Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Liu,

Sethi,

et al. 2024

Semin Liver Dis

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Liver transplantation (LT) is a highly effective treatment for carefully selected patients with hepatocellular carcinoma (HCC). In this review, we explored the development of LT selection criteria and organ allocation policies, comparing original data to underscore their historical progression into the intricate task of quantitatively estimating pre- and post-LT survivals. We emphasized the role of biomarkers such as serum AFP, DCP, circulating tumor cells, and circulating tumor DNA in predicting patient outcomes. Additionally, we examined the transplant-associated survival benefits and the difficulties in accurately calculating these benefits. We also reviewed recent advancements in targeted therapy and checkpoint inhibitors for advanced, inoperable HCC and projected their integration into liver transplantation for HCC. We further discussed the growing use of living donor liver transplants in the United States and compared its outcomes with those of deceased donor liver transplants. Furthermore, we examined the progress in machine perfusion techniques, which have shown potential in improving patient outcomes and enlarging the donor pool. These advancements present opportunities to enhance LT patient survivals, refine selection criteria, establish new priority metrics, develop innovative bridging and downstaging strategies, and formulate redesigned LT strategies for HCC treatments.

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Section: Immune Checkpoint Inhibitorsmentioning

confidence: 99%

Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Liu,

Sethi,

et al. 2024

Semin Liver Dis

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“…The compelling outcomes achieved with ICI in the advanced HCC setting have laid the foundation for considering ICI as a downstaging strategy, broadening liver transplantation criteria [27,29,31,33,34,35 ▪▪ ,36 ▪ ,37,42]. The ultimate objective is to formulate a personalized immunotherapy regimen tailored to individual resistance and response profiles, guided by tumor antigen peptides-MHC complexes (MHC) within the HCC tumoral microenvironment.…”

Section: Future Perspectivesmentioning

confidence: 99%

Immunotherapy for transplantation of hepatocellular carcinoma: the next frontier in adjunctive therapy

Tabrizian,

Zeitlhoefler,

Hassan

et al. 2023

Current Opinion in Organ Transplantation

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Purpose of review The increasing success of liver transplantation in hepatocellular carcinoma (HCC) drives an ever-evolving search for innovative strategies to broaden eligible patients’ pools. Recent advances in immuno-oncology have turned the spotlight on immune checkpoint inhibitors (ICIs). This review offers an updated overview of ICIs in liver transplantation for HCC, exploring neoadjuvant and adjuvant approaches and addressing unanswered questions on safety, patients’ selection, and response predictors. Recent findings ICIs have transitioned from being a last-chance therapeutic hope to becoming an integral cornerstone in the treatment of advanced HCC, holding great promise as a compelling option not only to downstage patients for transplantation but also as an alternative strategy in addressing posttransplantation disease recurrence. Despite ongoing refinements in immunotherapeutic agents, the complex molecular pathways involved emphasize the need for a comprehensive approach to integrate immunotherapy in liver transplantation. Summary Initial concerns about graft rejection, with ICIs as a bridging therapy to liver transplantation, were successfully addressed using adequate immunosuppressants strategies and minimized with a sufficient washout period. Post-liver transplantation disease recurrence remains challenging, requiring a balance between effective therapy and preserving graft function. Emphasis should be placed on clinical trials validating the risk-benefit ratio of ICIs for liver transplantation, guiding appropriate patients’ selection, and establishing clear management pathways.

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“…The last decade witnessed a scientific revolutionof the transplant oncology field that provides an excellent option to treat patients with iCCA by liver transplant [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Two main scenarios are worth attention in the transplant perspective.…”

Section: Surgical Resection and Liver Transplantationmentioning

confidence: 99%

Newest Therapies for Cholangiocarcinoma: An Updated Overview of Approved Treatments with Transplant Oncology Vision

Zhang

Esmail

Mazzaferro

et al. 2022

Cancers

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A minority of cholangiocarcinoma (CCA) can be cured by surgical intervention (i.e., liver resection (LR) and liver transplantation (LT)). When modern criteria for LT are met, this intervention along with neoadjuvant treatments may achieve unprecedented survival in selected patients. Liver resection is associated with a median overall survival (OS) of 40 months, this number drastically decreases for unresectable advanced cholangiocarcinoma (CCA), which is treated with systemic therapy. The first-line chemotherapy regimen of gemcitabine and cisplatin is associated with a median overall survival of only 11.7 months. Since the Food and Drug Administration (FDA)’s approval of the isocitrate dehydrogenase (IDH) 1 inhibitor ivosidenib in August 2021, there has been increasing interest in targeted therapy for CCA patients harboring mutations in fibroblast growth factor receptor (FGFR) 2, neurotrophic receptor tyrosine kinase (NTRK), B-raf kinase (BRAF), and HER2. At the same time, immunotherapy with immune checkpoint inhibitors isalso being used in relapsed CCA. This review looks into the most recently completed and ongoing studies of targeted therapy as monotherapy or in combination with chemo- and/or immunotherapy. Whether it is resection, liver transplant, radiotherapy, chemotherapy, immunotherapy, targeted therapy, or any combination of these treatment modalities, great strides are being made to improve outcomes for this challenging disease.

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

Cited by 32 publications

References 27 publications

Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Immunotherapy for transplantation of hepatocellular carcinoma: the next frontier in adjunctive therapy

Newest Therapies for Cholangiocarcinoma: An Updated Overview of Approved Treatments with Transplant Oncology Vision

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