Impact of pre-transplant immune checkpoint inhibitor use on post-transplant outcomes in HCC: A systematic review and individual patient data meta-analysis

被引：11

作者：

Rezaee-Zavareh, Mohammad Saeid ^{[1
]}

Yeo, Yee Hui ^{[2
]}

Wang, Tielong ^{[3
,4
,5
]}

Guo, Zhiyong ^{[3
,4
,5
]}

Tabrizian, Parissa ^{[6
]}

Ward, Stephen C. ^{[7
]}

Barakat, Fatma ^{[8
]}

Hassanein, Tarek I. ^{[8
]}

Dave, Shravan ^{[9
]}

Ajmera, Veeral ^{[9
]}

Bhoori, Sherrie ^{[10
]}

Mazzaferro, Vincenzo ^{[10
,11
]}

Chascsa, David M. H. ^{[12
,13
]}

Liu, Margaret C. ^{[12
]}

Aby, Elizabeth S. ^{[14
]}

Lake, John R. ^{[14
]}

Sogbe, Miguel ^{[15
,16
,17
]}

Sangro, Bruno ^{[15
,16
,17
]}

Abdelrahim, Maen ^{[18
,19
,20
]}

Esmail, Abdullah ^{[18
,20
,21
]}

Schmiderer, Andreas ^{[22
]}

Chouik, Yasmina ^{[23
,24
]}

Rudolph, Mark ^{[25
]}

Sohal, Davendra ^{[25
]}

Giudicelli, Heloise ^{[26
]}

Allaire, Manon ^{[26
,27
,36
]}

Akce, Mehmet ^{[28
]}

Guadagno, Jessica ^{[29
]}

Tow, Clara Y. ^{[30
,31
]}

Massoumi, Hatef ^{[32
]}

De Simone, Paolo ^{[33
]}

Kang, Elise ^{[34
]}

Gartrell, Robyn D. ^{[34
,35
]}

Martinez, Mercedes

Paz-Fumagalli, Ricardo ^{[37
]}

Toskich, Beau B. ^{[38
]}

Tran, Nguyen H. ^{[39
]}

Solino, Gabriela Azevedo ^{[40
]}

Pacheco, Dra Mariana Poltronieri ^{[41
]}

Kalman, Richard S. ^{[42
]}

Agopian, Vatche G. ^{[43
]}

Mehta, Neil ^{[44
]}

Parikh, Neehar D. ^{[45
]}

Singal, Amit G. ^{[46
]}

Yang, Ju Dong ^{[2
,47
,48
]}

机构：

[1] Middle East Liver Dis Ctr, Tehran 1417935840, Iran

[2] Cedars Sinai Med Ctr, Karsh Div Gastroenterol & Hepatol, 8900 Beverly Blvd, Los Angeles, CA 90048 USA

[3] Sun Yat Sen Univ, Affiliated Hosp 1, Organ Transplant Ctr, Guangzhou, Peoples R China

[4] Guangdong Prov Key Lab Organ Donat & Transplant Im, Guangzhou, Peoples R China

[5] Guangdong Prov Int Cooperat Base Sci & Technol Org, Guangzhou, Peoples R China

[6] Mt Sinai Med Ctr, Recanati Miller Transplantat Inst, New York, NY USA

[7] Icahn Sch Med Mt Sinai, Dept Pathol Mol & Cell Based Med, New York, NY USA

[8] Southern Calif Liver Ctr, 131 Orange Ave,Suite 101, Coronado, CA 92118 USA

[9] Univ Calif San Diego, Dept Med, Div Gastroenterol & Hepatol, La Jolla, CA USA

[10] Fdn IRCCS Ist Nazl Tumori Milano, HPB Surg Hepatol & Liver Transplantat, Milan, Italy

[11] Univ Milan, Dept Oncol & Hematooncol, Milan, Italy

[12] Mayo Clin Arizona, Div Gastroenterol & Hepatol, 5777 E Mayo Blvd, Phoenix, AZ 85054 USA

[13] Mayo Clin Arizona, Transplant Ctr, 5777 E Mayo Blvd, Phoenix, AZ 85054 USA

[14] Univ Minnesota, Div Gastroenterol Hepatol & Nutr, Minneapolis, MN USA

[15] Clin Univ Navarra, Liver Unit & HPB Oncol Area, Pamplona, Spain

[16] Clin Univ Navarra, HPB Oncol Area, Pamplona, Spain

[17] CIBEREHD, Pamplona, Spain

[18] Houston Methodist Neal Canc Ctr, Dept Med Oncol, Sect GI Oncol, Houston, TX 77030 USA

[19] Houston Methodist Res Inst, Cockrell Ctr Adv Therapeut Phase Program 1, Houston, TX 77030 USA

[20] Weill Cornell Med Coll, Dept Med, New York, NY 10021 USA

[21] Houston Methodist Res Inst, Canc Clin Trials, Houston, TX 77030 USA

[22] Med Univ Innsbruck, Dept Internal Med Gastroenterol Hepatol Endocrinol, Innsbruck, Austria

[23] Ctr Natl Rech Sci, Canc Res Ctr Lyon CRCL, U1052, UMR5286, Lyon, France

[24] Hosp Civils Lyon, Hop Croix Rousse, Dept Hepatol, Lyon, France

[25] Univ Cincinnati, Dept Internal Med, Div Hematol Oncol, Cincinnati, OH USA

[26] Sorbonne Univ, Hop Univ Pitie Salpetriere, AP HP, Serv Hepatogastroenterol, Paris, France

[27] Ctr Rech Cordeliers, INSERM, UMR 1138, F-75006 Paris, France

[28] Univ Alabama Birmingham, Heersink Sch Med, ONeal Comprehens Canc Ctr, Div Hematol & Oncol,Dept Med, Birmingham, AL USA

[29] Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA USA

[30] Montefiore Med Ctr, Albert Einstein Coll Med, Bronx, NY 10467 USA

[31] Albert Einstein Coll Med, Bronx, NY USA

[32] Lenox Hill Hosp NSLIJ, Northwell 261 East 78th St,Floor 4, New York, NY 10075 USA

[33] Univ Pisa, Hepatobiliary Surg & Liver Transplantat, Med Sch Hosp, Via Paradisa 2, I-56124 Pisa, Italy

[34] Columbia Univ Irving Med Ctr, Pediat, Div Pediat Hematol Oncol, New York, NY USA

[35] Johns Hopkins Sch Med, Dept Oncol, Div Pediat Oncol, Baltimore, MD USA

[36] Columbia Univ, Vagelos Coll Phys & Surg, Dept Pediat, New York, NY USA

[37] Mayo Clin Florida, 4500 San Pablo Rd, Jacksonville, FL 32224 USA

[38] Mayo Clin Florida, Div Intervent Radiol, Jacksonville, FL 32224 USA

[39] Mayo Clin, Dept Oncol, Rochester, MN 55905 USA

[40] Escola Super Ciencias Santa Casa de Misericordia V, Dept Internal Med, Vitoria, ES, Brazil

[41] Escola Super Ciencias Santa Casa de Misericordia V, Dept Gastroenterol & Hepatol, Vitoria, ES, Brazil

[42] Einstein Healthcare Network, Div Hepatol, Dept Med, Philadelphia, PA USA

[43] Univ Calif Los Angeles, Dumont Univ Calif Los Angeles, David Geffen Sch Med, Transplant Ctr, Los Angeles, CA USA

[44] Univ Calif San Francisco, Dept Med, Div Gastroenterol & Hepatol, San Francisco, CA USA

[45] Univ Michigan, Div Gastroenterol & Hepatol, Ann Arbor, MI USA

[46] Univ Texas Southwestern Med Ctr, Dept Internal Med, Dallas, TX USA

[47] Cedars Sinai Med Ctr, Comprehens Transplant Ctr, 8900 Beverly Blvd, Los Angeles, CA 90048 USA

[48] Cedars Sinai Med Ctr, Samuel Oschin Comprehens Canc Inst, 8900 Beverly Blvd, Los Angeles, CA 90048 USA

来源：

JOURNAL OF HEPATOLOGY | 2025年 / 82卷 / 01期

关键词：

Immune Checkpoint Inhibitors; Hepatocellular Carcinoma; Liver Neoplasms; Liver Transplantation; Graft Rejection; Recurrence; RESECTABLE HEPATOCELLULAR-CARCINOMA; LIVER-TRANSPLANTATION; MILAN CRITERIA; OPEN-LABEL; IMMUNOTHERAPY; NIVOLUMAB; THERAPY; BLOCKADE; FUTURE;

D O I：

10.1016/j.jhep.2024.06.042

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background & Aims: Treatment with immune checkpoint inhibitors (ICIs) for hepatocellular carcinoma (HCC) prior to liver transplantation (LT) has been reported; however, ICIs may elevate the risk of allograft rejection and impact other clinical outcomes. This study aims to summarize the impact of ICI use on post-LT outcomes. Methods: In this individual patient data meta-analysis, we searched databases to identify HCC cases treated with ICIs before LT, detailing allograft rejection, HCC recurrence, and overall survival. We performed Cox regression analysis to identify risk factors for allograft rejection. Results: Among 91 eligible patients, with a median (IQR) follow-up of 690.0 (654.5) days, there were 24 (26.4%) allograft rejections, 9 (9.9%) HCC recurrences, and 9 (9.9%) deaths. Age (adjusted hazard ratio [aHR] per 10 years 0.72, 95% CI 0.53-0.99, p = 0.044) and ICI washout time (aHR per 1 week 0.92, 95% CI 0.86-0.99, p = 0.022) were associated with allograft rejection. The median (IQR) washout period for patients with <= 20% probability of allograft rejection was 94 (196) days. Overall survival did not differ between cases with and without allograft rejection (log-rank test, p = 0.2). Individuals with HCC recurrence had fewer median (IQR) ICI cycles than those without recurrence (4.0 [1.8] vs. 8.0 [9.0]; p = 0.025). The proportion of patients within Milan post-ICI was lower for those with recurrence vs. without (16.7% vs. 65.3%, p = 0.032). Conclusion: Patients have acceptable post-LT outcomes after ICI therapy. Age and ICI washout length relate to the allograft rejection risk, and a 3-month washout may reduce it to that of patients without ICI exposure. Number of ICI cycles and tumor burden may affect recurrence risk. Large prospective studies are necessary to confirm these associations. (c) 2024 European Association for the Study of the Liver. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

引用

页码：107 / 119

页数：14

共 65 条

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