Immunotherapy after liver transplantation: Where are we now?
Immunotherapy after liver transplantation: Where are we now?
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DOI：
10.4240/wjgs.v13.i10.1267
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发表时间：
2021-10-27
影响因子：
2
通讯作者：
Chok KSH
中科院分区：
文献类型：
--
作者：
Au KP;Chok KSH
关于肝移植术后免疫治疗的安全性及其治疗肝移植术后肝细胞癌（HCC）复发的有效性的证据有限。评估肝移植后免疫治疗的安全性及其治疗肝移植后肝癌复发的有效性。进行了文献综述，以确定既往接受肝移植和随后接受免疫治疗的患者。我们回顾了排斥率和排斥的危险因素。在接受HCC治疗的患者中，评价了肿瘤学结局，包括客观缓解率、无进展生存期（PFS）和总生存期（OS）。我们从16篇出版物中确定了25例患者，从我们的机构数据库中确定了3例患者（总计n = 28）。排斥率为32%（n = 9）。早期死亡率为21%（n = 6），主要与急性排斥反应有关（18%，n = 5）。发生急性排斥反应的患者在移植后较早接受免疫治疗（中位数2.9年vs 5.3年，P = 0.02），其移植物活检可能更频繁地出现程序性死亡配体-1阳性（100% vs 33%，P = 0.053）。他们的PFS（1.0 ± 0.1个月vs 3.5 ± 1.1个月，P = 0.02）和OS（1.0 ± 0.1个月vs 19.2 ± 5.5个月，P = 0.001）低于无排斥反应的患者。在19例接受HCC治疗的患者中，排斥率为32%（n = 6），总体客观缓解率为11%。免疫治疗后中位PFS和OS分别为2.5 ± 1.0和7.3 ± 2.7个月。排斥风险是肝移植受者使用免疫治疗的主要障碍。需要进一步研究排斥反应的潜在危险因素。
There is limited evidence on the safety of immunotherapy use after liver transplantation and its efficacy in treating post-liver transplant hepatocellular carcinoma (HCC) recurrence. To assess the safety of immunotherapy after liver transplant and its efficacy in treating post-liver transplant HCC recurrence. A literature review was performed to identify patients with prior liver transplantation and subsequent immunotherapy. We reviewed the rejection rate and risk factors of rejection. In patients treated for HCC, the oncological outcomes were evaluated including objective response rate, progression-free survival (PFS), and overall survival (OS). We identified 25 patients from 16 publications and 3 patients from our institutional database (total n = 28). The rejection rate was 32% (n = 9). Early mortality occurred in 21% (n = 6) and was mostly related to acute rejection (18%, n = 5). Patients who developed acute rejection were given immunotherapy earlier after transplantation (median 2.9 years vs 5.3 years, P = 0.02) and their graft biopsies might be more frequently programmed death ligand-1-positive (100% vs 33%, P = 0.053). Their PFS (1.0 ± 0.1 mo vs 3.5 ± 1.1 mo, P = 0.02) and OS (1.0 ± 0.1 mo vs 19.2 ± 5.5 mo, P = 0.001) compared inferiorly to patients without rejection. Among the 19 patients treated for HCC, the rejection rate was 32% (n = 6) and the overall objective response rate was 11%. The median PFS and OS were 2.5 ± 1.0 mo and 7.3 ± 2.7 mo after immunotherapy. Rejection risk is the major obstacle to immunotherapy use in liver transplant recipients. Further studies on the potential risk factors of rejection are warranted.
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DOI：
10.7759/cureus.11150
发表时间：
2020-10-25
期刊：
Cureus
影响因子：
--
作者：
Al Jarroudi O;Ulusakarya A;Almohamad W;Afqir S;Morere JF
通讯作者：
Morere JF
影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
0.8
作者：
de'Angelis, Nicola;Landi, Filippo;Azoulay, Daniel
通讯作者：
Azoulay, Daniel
影响因子：
3.9
作者：
Ranganath, Harsha A.;Panella, Timothy J.
通讯作者：
Panella, Timothy J.
影响因子：
2.3
作者：
Gassmann D;Weiler S;Mertens JC;Reiner CS;Vrugt B;Nägeli M;Mangana J;Müllhaupt B;Jenni F;Misselwitz B
通讯作者：
Misselwitz B