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Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation

Hepatocellular carcinoma (HCC) is an aggressive primary liver neoplasm that, according to tumor stage, can be treated with resection, transplantation, locoregional treatment options, or systemic therapy. Although interventions only in early-stage disease can offer complete tumor regression, systemic...

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Autores principales: Ouranos, Konstantinos, Chatziioannou, Anthi, Goulis, Ioannis, Sinakos, Emmanouil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693898/
https://www.ncbi.nlm.nih.gov/pubmed/36437845
http://dx.doi.org/10.5500/wjt.v12.i11.331
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author Ouranos, Konstantinos
Chatziioannou, Anthi
Goulis, Ioannis
Sinakos, Emmanouil
author_facet Ouranos, Konstantinos
Chatziioannou, Anthi
Goulis, Ioannis
Sinakos, Emmanouil
author_sort Ouranos, Konstantinos
collection PubMed
description Hepatocellular carcinoma (HCC) is an aggressive primary liver neoplasm that, according to tumor stage, can be treated with resection, transplantation, locoregional treatment options, or systemic therapy. Although interventions only in early-stage disease can offer complete tumor regression, systemic therapy in advanced disease can significantly prolong overall survival, according to pub lished clinical trials. The emergence of immunotherapy in the field of cancer therapy has had a positive impact on patients with HCC, resulting in atezolizumab–bevacizumab currently being the first-line option for treatment of advanced HCC. In light of this, application of immunotherapy in the preoperative process could increase the number of patients fulfilling the criteria for liver transplantation (LT). Implementation of this approach is faced with challenges regarding the safety of immunotherapy and the possibly increased risk of re jection in the perioperative period. Case reports and clinical trials assessing the safety profile and effectiveness of neoadjuvant immunotherapy, highlight important aspects regarding this newly evolving approach to HCC management. More studies need to be conducted in order to reach a consensus regarding the optimal way to administer immunotherapy prior to LT. In this review, we sum marize the role, safety profile and future considerations regarding the use of neoadjuvant immunotherapy prior to LT in patients with HCC.
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spelling pubmed-96938982022-11-26 Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation Ouranos, Konstantinos Chatziioannou, Anthi Goulis, Ioannis Sinakos, Emmanouil World J Transplant Review Hepatocellular carcinoma (HCC) is an aggressive primary liver neoplasm that, according to tumor stage, can be treated with resection, transplantation, locoregional treatment options, or systemic therapy. Although interventions only in early-stage disease can offer complete tumor regression, systemic therapy in advanced disease can significantly prolong overall survival, according to pub lished clinical trials. The emergence of immunotherapy in the field of cancer therapy has had a positive impact on patients with HCC, resulting in atezolizumab–bevacizumab currently being the first-line option for treatment of advanced HCC. In light of this, application of immunotherapy in the preoperative process could increase the number of patients fulfilling the criteria for liver transplantation (LT). Implementation of this approach is faced with challenges regarding the safety of immunotherapy and the possibly increased risk of re jection in the perioperative period. Case reports and clinical trials assessing the safety profile and effectiveness of neoadjuvant immunotherapy, highlight important aspects regarding this newly evolving approach to HCC management. More studies need to be conducted in order to reach a consensus regarding the optimal way to administer immunotherapy prior to LT. In this review, we sum marize the role, safety profile and future considerations regarding the use of neoadjuvant immunotherapy prior to LT in patients with HCC. Baishideng Publishing Group Inc 2022-11-18 2022-11-18 /pmc/articles/PMC9693898/ /pubmed/36437845 http://dx.doi.org/10.5500/wjt.v12.i11.331 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 Review
Ouranos, Konstantinos
Chatziioannou, Anthi
Goulis, Ioannis
Sinakos, Emmanouil
Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation
title Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation
title_full Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation
title_fullStr Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation
title_full_unstemmed Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation
title_short Role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation
title_sort role of immunotherapy in downsizing hepatocellular carcinoma prior to liver transplantation
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693898/
https://www.ncbi.nlm.nih.gov/pubmed/36437845
http://dx.doi.org/10.5500/wjt.v12.i11.331
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