Safety of PD-1 inhibitor in preoperative treatment of liver transplantation for liver cancer
10.3969/j.issn.1674-7445.2021.04.011
- VernacularTitle:PD-1抑制剂用于肝癌肝移植术前治疗的安全性探讨
- Author:
Zhaobo LIU
1
;
Jushan WU
;
Dongdong LIN
;
Guangming LI
Author Information
1. General Surgery Center, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
- Publication Type:Research Article
- Keywords:
Liver transplantation;
Immune checkpoint inhibitor;
Programmed cell death protein 1 inhibitor;
Primary liver cancer;
Immune-related adverse event;
Rejection;
Nivolumab;
Sintilimab;
Pembrolizumab;
Camrelizumab
- From:
Organ Transplantation
2021;12(4):445-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety of programmed cell death protein 1 (PD-1) inhibitor in the treatment of primary liver cancer (liver cancer) before liver transplantation. Methods Clinical data of 7 recipients given with PD-1 inhibitor before liver transplantation for liver cancer were retrospectively analyzed. The incidence of immune-related adverse event (irAE) and clinical prognosis of the recipients were summarized. The safety of PD-1 inhibitor in recipients prior to liver transplantation for liver cancer was evaluated. Results Seven recipients were treated with PD-1 inhibitor with 1-20 courses before liver transplantation for liver cancer. The time interval from drug withdrawal to liver transplantation was 6-120 d. Five recipients suffered from irAE of different degrees, including fatigue in 3 cases, fever in 2 cases, alopecia in 2 cases, rash in 1 case, nausea in 1 case and myocarditis in 1 case, respectively. A majority of these irAE were classified as grade Ⅰ-Ⅱ. One recipient died from grade Ⅴ irAE (fatal myocarditis). One recipient developed rejection at postoperative 7 d, which were mitigated after glucocorticoid pulse therapy combined with increased dosage of tacrolimus. Conclusions PD-1 inhibitor can be applied in preoperative treatment before liver transplantation for liver cancer. Nevertheless, the incidence of irAE and postoperative rejection should be intimately monitored.
