Immune checkpoint inhibitors combined with TKIs as a bridge therapy for advanced HCC before liver transplantation
10.3760/cma.j.cn113884-20210806-00254
- VernacularTitle:PD-1抑制剂联合TKIs治疗中晚期肝细胞癌后实施肝移植的可行性探讨
- Author:
Binwei DUAN
1
,
2
;
Wenlei LI
;
Junning CAO
;
Wenwen ZHANG
;
Bingyang HU
;
Jushan WU
;
Gongming ZHANG
;
Yabo OUYANG
;
Shichun LU
;
Guangming LI
Author Information
1. 首都医科大学附属北京佑安医院普通外科中心&
2. 器官移植中心，北京 100069
- Keywords:
Carcinoma, hepatocellular;
Liver transplantation;
Programmed death-1 inhibitors;
Tyrosine kinase inhibitors
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(1):28-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and efficacy of combining programmed death-1 (PD-1) with tyrosine kinase inhibitors (TKIs) in patients with advanced hepatocellular carcinoma (HCC) before liver transplantation(LT).Methods:The data of six males with a mean ± s. d. age of (57.5±4.3) years who were treated with PD-1 inhibitors combined with TKIs for advanced HCC before LT at Beijing You'an Hospital, Capital Medical University and the First Medical Center of Chinese PLA General Hospital were retrospectively analysed. The tumor stagings, the use of PD-1 inhibitors and TKIs with their discontinuation in pre-LT/post-LT liver function recovery durations, incidences of complication. The tumor recurrence and disease-free survival rates were determined on follow-up of these patients at outpatients clinics.Results:For the 6 patients included in this study, four patients were classified by the Barcelona Clinic Liver Cancer Staging (BCLC) as C and the China Liver Cancer Staging (CNLC) as Ⅲa, and two patients were classified by the BCLC staging as B and the CNLC asⅡb. The mean cycle of PD-1 inhibitor used was 5.5 (1-20), and the mean duration of PD-1 inhibitor discontinuation was 19.5 (12-45) days pre-LT. All patients who were treated with PD-1 inhibitors combined with TKIs reached the liver transplantation standard, and all successfully underwent orthotopic liver transplantation. The liver function recovered well without any serious complications post-LT. All the patients survived without developing any acute rejection or other complications. The follow-up time ranged from 8.2 to 27.3 months, with a median of 11.9 months. No patients had died, and 2 patients developed tumor recurrence. The median (range) tumor-free survival time was 10.9 (2.9-27.3) months.Conclusion:Patients with advanced HCC could benefit from combined PD-1 inhibitors with TKIs therapy pre-LT. There were no increased incidences of acute rejection and other complications post-LT.
