Castelli Giulia, Burra Patrizia, Giacomin Anna, Vitale Alessandro, Senzolo Marco, Cillo Umberto, Farinati Fabio
Department of Surgery, Oncology, and Gastroenterology, Padua University School of Medicine, Padua, Italy.
Liver Transpl. 2014 Sep;20(9):1021-8. doi: 10.1002/lt.23911. Epub 2014 Aug 4.
Liver transplantation (LT) is an established treatment for hepatocellular carcinoma (HCC), and sorafenib (SFN) is a validated treatment for patients harboring advanced tumors. It is still not clear whether the combination of the 2 treatments, with SFN used in the neoadjuvant, adjuvant, or recurrence setting, is useful and cost-effective. This article summarizes the present evidence in favor of and against the use of SFN in the setting of LT for HCC, and it also includes the problem of toxicity, particularly when mammalian target of rapamycin inhibitors, which play a central role in regulating cellular growth and proliferation, are used as immunosuppressants. Overall, the data do not support the use of SFN in the pre- or post-LT setting as adjuvant therapy, and additional studies are needed to reach sound conclusions on the topic.
肝移植（LT）是肝细胞癌（HCC）的一种既定治疗方法，而索拉非尼（SFN）是对晚期肿瘤患者的一种有效治疗方法。目前尚不清楚这两种治疗方法联合使用，即在新辅助、辅助或复发情况下使用SFN是否有用且具有成本效益。本文总结了支持和反对在HCC肝移植中使用SFN的现有证据，还包括毒性问题，特别是当在调节细胞生长和增殖中起核心作用的雷帕霉素哺乳动物靶点抑制剂用作免疫抑制剂时。总体而言，现有数据不支持在肝移植前后使用SFN作为辅助治疗，需要更多研究才能就该主题得出可靠结论。
