mTOR inhibitors and sorafenib for recurrent heptocellular carcinoma after orthotopic liver transplantation

Waidmann, Oliver; Hofmann, W; Zeuzem, Stefan; Trojan, Joerg

doi:10.1016/j.jhep.2010.08.038

Cited by 35 publications

(18 citation statements)

References 11 publications

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“…[37][38][39][40][41][42][43][44][45][46][47][48][49][50] Most of the studies reported were retrospective evaluations, consistently demonstrating the feasibility of treatment for cancers and for sparing renal function. The most recent results obtained are highly representative, due to the size of the study and its multicenter design 50 or an interesting design based on the time of introduction and renal function at the time of transplantation.…”

Section: Reported Experiences With the Use Of Erl In Liver And Lung Tmentioning

confidence: 94%

“…The available data are reported in Table 1a and 1b, as the use of ERL de novo [34][35][36] and for conversion [37][38][39][40][41][42][43][44][45][46][47][48][49][50] in liver transplantation (LiT), and in Table 2 for the use of ERL in lung transplantation (LuTx). [51][52][53][54][55][56][57][58][59] Liver transplantation…”

Section: Reported Experiences With the Use Of Erl In Liver And Lung Tmentioning

confidence: 99%

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The Role of Everolimus in Lung and Liver Transplantation

2011

Clinical Medicine Reviews in Therapeutics

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Everolimus (ERL) is a recently developed mTOR inhibitor. This rapamycin analog is used to prevent acute rejection during kidney and heart transplantation. We review here published clinical trials and experiences concerning potential applications of ERL in liver and lung transplantation. Most of the data concern conversion for rescue situations, but a small number of studies have been conducted in de novo patients. In most cases, everolimus was used to spare renal function and to minimize calcineurine inhibitor use, but also, due to the antiproliferative properties of the drugs of this class, to control malignancy. Safety issues are an important consideration when deciding whether to maintain a patient on treatment. Therapeutic drug monitoring is strongly recommended, to achieve a mean whole-blood trough concentration of 6 ng/mL, with doses of 0.5 to 1.5 mg administered twice daily. There is solid evidence that ERL is a feasible and effective treatment, for a selected subset of patients, in the contexts of liver and lung transplantation.

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Section: Reported Experiences With the Use Of Erl In Liver And Lung Tmentioning

confidence: 94%

Section: Reported Experiences With the Use Of Erl In Liver And Lung Tmentioning

confidence: 99%

The Role of Everolimus in Lung and Liver Transplantation

2011

Clinical Medicine Reviews in Therapeutics

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“…In the context of liver transplantation there are only retrospective cohort studies that have looked at the effect of sorafenib on recurrent HCC (77,(80)(81)(82). How sorafenib is used and in combination with which immunosuppression regime is becoming established in the post-transplant patient with HCC recurrence (83).…”

Section: Immunosuppression and Sorafenibmentioning

confidence: 99%

Optimization of immunosuppressive medication upon liver transplantation against HCC recurrence

Khorsandi¹,

Heaton²

2016

Transl. Gastroenterol. Hepatol.

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“…Two large randomized control trials have demonstrated that it can increase the survival of patients with advanced HCC by approximately 2 to 3 months . However, LT patients were excluded from those randomized trials; therefore, only a few retrospective cohort studies have investigated sorafenib in the setting of transplantation . In a recent case‐control study, sorafenib was reported to be associated with a survival benefit for patients with recurrent HCC in comparison with the best supportive care .…”

Section: Choice Of Immunosuppressants During the Prevention Or Treatmmentioning

confidence: 99%

“…It is not surprising that a combination of sorafenib and rapalogs has been favored in the LT setting because rapalogs have the potential to inhibit cellular proliferation and angiogenesis by targeting the mTOR pathway . However, the tolerability of sorafenib is rather poor for LT patients either with or without mTOR inhibitors, and this, in turn, hampers the proper assessment of its efficacy. A phase 1 trial has attempted to determine the maximum tolerated dose of everolimus in combination with standard‐dose sorafenib in patients with advanced HCC.…”

Section: Choice Of Immunosuppressants During the Prevention Or Treatmmentioning

confidence: 99%

Rationale of personalized immunosuppressive medication for hepatocellular carcinoma patients after liver transplantation

et al. 2014

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Liver transplantation is the only potentially curative treatment for hepatocellular carcinoma (HCC) that is not eligible for surgical resection. However, disease recurrence is the main challenge to the success of this treatment. Immunosuppressants that are universally used after transplantation to prevent graft rejection could potentially have a significant impact on HCC recurrence. Nevertheless, current research is exclusively focused on mammalian target of rapamycin inhibitors, which are thought to be the only class of immunosuppressive agents that can reduce HCC recurrence. In fact, substantial evidence from the bench to the bedside indicates that other classes of immunosuppressants may also exert diverse effects; for example, inosine monophosphate dehydrogenase inhibitors potentially have antitumor effects. In this article, we aim to provide a comprehensive overview of the potential effects of different types of immunosuppressants on HCC recurrence and their mechanisms of action from both experimental and clinical perspectives. To ultimately improve the outcomes of HCC patients after transplantation, we propose a concept and approaches for developing personalized immunosuppressive medication to be used either as immunosuppression maintenance or during the prevention/treatment of HCC recurrence. Liver Transpl 20:261-269, 2014. V C 2013 AASLD.

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mTOR inhibitors and sorafenib for recurrent heptocellular carcinoma after orthotopic liver transplantation

Cited by 35 publications

References 11 publications

The Role of Everolimus in Lung and Liver Transplantation

The Role of Everolimus in Lung and Liver Transplantation

Optimization of immunosuppressive medication upon liver transplantation against HCC recurrence

Rationale of personalized immunosuppressive medication for hepatocellular carcinoma patients after liver transplantation

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