1. Outcomes of Sorafenib for Recurrent Hepatocellular Carcinoma After Liver Transplantation in the Era of Combined and Sequential Treatments.
- Author
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Tovoli F, Pallotta DP, Sansone V, Iavarone M, De Giorgio M, Ielasi L, Di Costanzo GG, Giuffrida P, Sacco R, Pressiani T, Di Donato MF, Trevisani F, Fagiuoli S, Piscaglia F, and Granito A
- Subjects
- Humans, Sorafenib therapeutic use, Retrospective Studies, Prospective Studies, Neoplasm Recurrence, Local epidemiology, Carcinoma, Hepatocellular drug therapy, Carcinoma, Hepatocellular surgery, Liver Transplantation adverse effects, Liver Neoplasms drug therapy, Liver Neoplasms surgery
- Abstract
Background: Sorafenib and other tyrosine kinase inhibitors are the current standard of care for hepatocellular carcinoma (HCC) recurring after liver transplantation (LT). Sorafenib is sometimes regarded as a scarcely effective treatment in this setting because of some studies showing a short overall survival (OS) indirectly compared with historical series of nontransplanted patients. Additional data from multicenter prospective studies are needed before drawing definite conclusions., Methods: Retrospective analyses of a large prospective multicenter dataset of sorafenib-treated HCC patients to report the characteristics and outcomes of LT recipients (n = 81)., Results: At the baseline, LT patients had key prognostic features (high prevalence of metastatic disease, and low prevalence of macrovascular invasion, α-fetoprotein >400 ng/mL, ALBI grade >1, performance status >0) that differentiated them from the typical populations of non-LT patient reported in clinical trials and observational studies. Moreover, a relevant proportion of LT patients received concurrent locoregional (12.3%) and postprogression systemic treatments (34.2%), resulting in a median OS of 18.7 mo., Conclusions: Multimodal and sequential treatments are relatively frequent in post-LT HCC patients and contribute to a remarkable OS, together with favorable baseline characteristics. Despite the impossibility of matching with non-LT patients, our results indirectly suggest that the metastatic nature of post-LT recurrence and concurrent antirejection regimens should not discourage systemic treatments., Competing Interests: F.T. has served as a consultant for Bayer, Ipsen, and Eisai and an advisory board member for Laforce. M.I.: speaking/teaching, consultant, and the advisory board for Bayer, Gilead Sciences, BMS, Janssen, Ipsen, MSD, BTG-Boston Scientific, AbbVie, Guerbet, and EISAI. M.D.G. received honoraria for serving on advisory boards for Eisai and Bayer. F.T. is an advisor and a consultant for Bayer and an advisory board member for Sirtex, Alfasigma, and Bristol-Myers Squibb. F.P. is a consultant for AstraZeneca, Bayer AG, EISAI, GE, and Tiziana Life Sciences; Speaker bureau honoraria: Bayer AG, Bracco, EISAI, and Laforce; research contract with Esaote. A.G. has served as a consultant for Bayer. The other authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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