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Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons
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 criteria. Although immunotherapy has dramatically improved survival...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790424/ https://www.ncbi.nlm.nih.gov/pubmed/35116109 http://dx.doi.org/10.4251/wjgo.v14.i1.163 |
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author | Luo, Yi Teng, Fei Fu, Hong Ding, Guo-Shan |
author_facet | Luo, Yi Teng, Fei Fu, Hong Ding, Guo-Shan |
author_sort | Luo, Yi |
collection | PubMed |
description | 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 criteria. Although 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 rejection. Nevertheless, 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 setting. Generally, immunotherapy mainly includes immune checkpoint inhibitors (ICIs), adoptive cell transfer (ACT) and vaccine therapy. ICIs, followed by ACT, have been most investigated in LT, with some promising results. Because 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 patients. In addition, the absence of effective biomarkers for identifying rejection and tumor response is still an unresolved barrier to successful clinical immunotherapy applications for LT. In this review, we comprehensively summarize the available evidence of immunotherapy used in LT that is specific to HCC. Moreover, we discuss clinically concerning issues regarding the concurrent goals of graft protection and antitumor response. |
format | Online Article Text |
id | pubmed-8790424 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-87904242022-02-02 Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons Luo, Yi Teng, Fei Fu, Hong Ding, Guo-Shan World J Gastrointest Oncol Minireviews 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 criteria. Although 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 rejection. Nevertheless, 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 setting. Generally, immunotherapy mainly includes immune checkpoint inhibitors (ICIs), adoptive cell transfer (ACT) and vaccine therapy. ICIs, followed by ACT, have been most investigated in LT, with some promising results. Because 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 patients. In addition, the absence of effective biomarkers for identifying rejection and tumor response is still an unresolved barrier to successful clinical immunotherapy applications for LT. In this review, we comprehensively summarize the available evidence of immunotherapy used in LT that is specific to HCC. Moreover, we discuss clinically concerning issues regarding the concurrent goals of graft protection and antitumor response. Baishideng Publishing Group Inc 2022-01-15 2022-01-15 /pmc/articles/PMC8790424/ /pubmed/35116109 http://dx.doi.org/10.4251/wjgo.v14.i1.163 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Minireviews Luo, Yi Teng, Fei Fu, Hong Ding, Guo-Shan Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons |
title | Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons |
title_full | Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons |
title_fullStr | Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons |
title_full_unstemmed | Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons |
title_short | Immunotherapy in liver transplantation for hepatocellular carcinoma: Pros and cons |
title_sort | immunotherapy in liver transplantation for hepatocellular carcinoma: pros and cons |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790424/ https://www.ncbi.nlm.nih.gov/pubmed/35116109 http://dx.doi.org/10.4251/wjgo.v14.i1.163 |
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