Standardized immunosuppressive protocol to prevent rejection under immunotherapy for post liver transplantation HCC recurrence: A French center's experience - 15/12/24
, Filomena Conti a, b, Olivier Scatton c, d, Dominique Thabut a, d, Manon Allaire a, eLiver Institute of la Pitié-Salpêtrière (LIPS)—University Hospital in Paris
Abstract |
In current guidelines, liver transplantation (LT) should be considered in patients with early-stage hepatocellular carcinoma (HCC) because of their lower risk of recurrence and excellent long-term overall survival (OS). To broaden curative opportunities in intermediate and advanced HCC, downstaging strategies are emerging and associated with similar OS compared to patients initially meeting LT criteria. These strategies may however expose these patients to higher HCC recurrence risk. HCC recurrence post LT is essentially metastatic and extrahepatic, and these patients’ prognosis is very poor. The treatments used in this case are tyrosine kinase inhibitors (TKIs) with a low response rate and bad tolerance. If immunotherapy is the new standard of care for advanced and metastatic HCC, scarce data about their administration in liver transplanted recipients in case of HCC recurrence are available. As immunosuppressive (IS) treatment and immunotherapy agents share common targets, utilization of immunotherapy in liver recipients remains complex and exposes patients to acute cellular rejection (ACR). We would like to share in this letter our center experience with eight patients that received immunotherapy post LT as long as a standardized specific IS regimen that aims to lower ACR risk and allow immunotherapy to be effective.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatocellular carcinoma, Liver transplantation, Immune checkpoints inhibitors, Graft rejection
Abbreviations : acr, apc, atezobev, hcc, is, lt, mmf, mTOR
Plan
| Financial support: None. |
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| Manon Allaire is acting as the submission's guarantor. |
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| All authors approved the final version of the manuscript. |
Vol 17
Article 100252- février 2025 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
