Journal
CURRENT CANCER DRUG TARGETS
Volume 20, Issue 9, Pages 720-727Publisher
BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1568009620666200520084415
Keywords
Immune checkpoint inhibitors; hepatocellular carcinoma; liver transplantation; case report; graft rejection; optimal immunomodulatory therapy
Categories
Funding
- Basic and Advanced Research Project of Science and Technology Commission of Chongqing Municipality [cstc2017jcyjBX0010]
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Background: Immune checkpoint modulators, such as the programmed death protein-1 (PD-1)/programmed death ligand-1 (P D-L) inhibitor, cytotoxic T-Lymphocyte-associated antigen 4 (CTLA-4) inhibitor have been investigated with encouraging results for hepatocellular carcinoma (HCC). I lowever, the safety of this strategy in patients with previous liver transplantation (LT) is not well studied. Objective: To explore the safety and feasibility of immune checkpoints inhibitors in recurrent and metastatic HCC patients on a background of LT. Methods: A case of recurrent, refractory, metastatic HCC after LT, where PD-1 inhibitor was initiated, was described and related literature was reviewed. Results: There was complete remission in lung metastases and the partial radiological response of metastatic retroperitoneal lymph node to the drug with no liver graft rejection after 13 cycles of PD-1 inhibitor injection. PD-1 inhibitor, at least in this patient, was verified to play an important role in controlling tumor progression and prolonging patient survival. Conclusion: This novel drug might he a useful method to allow doctors to guarantee a better chance for long-term survival in recurrent, metastatic HCC patients with the previous LT. However, it should he used with caution in allograft recipients due to the risk of acute graft rejection, further larger, prospective studies are needed to determine optimal immunomodulatory, therapy to achieve optimal anti-tumor efficacy with transplant liver preservation.
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