Immunotherapy in liver transplantation for hepatocellular carcinoma:Pros and cons
作者机构:Department of Liver Surgery and Organ TransplantationChangzheng HospitalNaval Medical UniversityShanghai 200003China
出 版 物:《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志(英文版)(电子版))
年 卷 期:2022年第14卷第1期
页 面:163-180页
核心收录:
学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
基 金:National Natural Science Foundation of China No.81702923 and No.81871262
主 题:Hepatocellular carcinoma Liver transplantation Immunotherapy Immune checkpoint inhibitors Adoptive cell transfer Immunosuppressant
摘 要:Liver transplantation(LT)has emerged as a curative strategy for hepatocellular carcinoma(HCC),but contributes to a higher predisposition to HCC recurrence in the immunosuppression context,especially for tumors beyond the Milan *** immunotherapy has dramatically improved survival for immunocompetent patients and has become the standard of care for a variety of tumors,including HCC,it is mainly used outside the scope of organ transplantation owing to potentially fatal allograft ***,accumulative evidence has expanded the therapeutic paradigms of immunotherapy for HCC,from downstaging or bridging management in the pretransplant setting to the salvage or adjuvant strategy in the posttransplant ***,immunotherapy mainly includes immune checkpoint inhibitors(ICIs),adoptive cell transfer(ACT)and vaccine ***,followed by ACT,have been most investigated in LT,with some promising *** of the complex tumor microenvironment and immunoreactivity when immunosuppressants are combined with immunotherapy,it is difficult to reach formulations for immunosuppressant adjustment and the optimal selection of immunotherapy as well as *** addition,the absence of effective biomarkers for identifying rejection and tumor response is still an unresolved barrier to successful clinical immunotherapy applications for *** this review,we comprehensively summarize the available evidence of immunotherapy used in LT that is specific to ***,we discuss clinically concerning issues regarding the concurrent goals of graft protection and antitumor response.