PD-1 inhibitor as bridge therapy to liver transplantation?

作者：Parissa Tabrizian, Sander S Florman, Myron Schwartz · 发表于：American Journal of Transplantation · 年份：2020 · DOI：10.1111/ajt.16448 · 被引用次数：158 · 研究领域：Cancer Immunotherapy and Biomarkers、Immune Cell Function and Interaction、Polyomavirus and related diseases

To the Editor: The use of antiprogrammed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) checkpoint inhibitors in the treatment of cancer has rapidly increased and is approved to treat hepatocellular carcinoma (HCC). PD-1 blockade has been discouraged in transplant candidates and recipients due to reports of severe rejection and graft loss.1Abdel-Wahab N Shah M Suarez-Almazor ME et al.Adverse events associated with immune checkpoint blockade in patients with cancer: a systematic review of case reports.PLoS One. 2016; 11 (e0160221.)Crossref PubMed Scopus (312) Google Scholar, 2Wang DY Johnson DB Davis EJ. Toxicities associated with PD-1/PD-L1 blockade.Cancer J. 2018; 24: 36-40Crossref PubMed Scopus (55) Google Scholar, 3Nordness MF Hamel S Godfrey CM et al.Fatal hepatic necrosis after nivolumab as a bridge to liver transplant for HCC: are checkpoint inhibitors safe for the pretransplant patient?.Am J Transplant. 2020; 20: 879-883Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar The clinical outcome of patients receiving immunotherapy before transplant, however, remains unknown. Between 2017 and 2020, nine patients with HCC were listed and successfully transplanted at a single center after receiving nivolumab as an element of pretransplant tumor treatment (Table 1). The mean age was 57 years; 67% were male. The most common underlying liver disease was hepatitis B (56%). Five patients (56%) had prior HCC resection at a median interval of 7 years; one...