Xie Man, Dang Zhi-Ping, Sun Xue-Guo, Zhang Bei, Zhang Qun, Tian Qiu-Ju, Cai Jin-Zhen, Rao Wei
Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Immunology, Medical College of Qingdao University, Qingdao, China.
Ther Adv Chronic Dis. 2022 May 19;13:20406223221099334. doi: 10.1177/20406223221099334. eCollection 2022.
Up to now, a variety of immune checkpoint inhibitors (ICIs) have been proved to have good therapeutic effects in the treatment of hepatocellular carcinoma (HCC). However, the effects of their applications in liver transplant (LT) recipients are still unclear. In this analysis report, the clinical applications and therapeutic effects of ICIs on LT recipients with hepatic tumor recurrence or carcinoma based on eight databases, including PubMed, EMBASE, Web of Science, Google Scholar, China National Knowledge Infrastructure, Wanfang Data, and CQVIP, were investigated. And the prior treatment, disease response, adverse reactions, and prognosis of patients with malignant tumors after LT and receiving ICI treatments were analyzed. After screening, a total of 28 articles with 47 recipients on the application of ICIs after LT were included. In these patients, their median age was 57 (14-71) years and the main type of tumor after LT was HCC (59.6%). The overall remission rate following ICI treatment was 29.8% (14/47) and the disease progression rate was 68.1% (32/47). Among all these patients, 31.9% (15/47) of patients had immune rejection; the median survival time was 6.5 (0.3-48) months, and the fatality rate was 61.7% (29/47). Considering that the therapeutic effect of ICIs in LT recipients with HCC recurrence or carcinoma is not ideal, ICI treatment should be carefully considered for LT patients, and further research is needed.
到目前为止,多种免疫检查点抑制剂(ICI)已被证明在肝细胞癌(HCC)治疗中具有良好的治疗效果。然而,它们在肝移植(LT)受者中的应用效果仍不明确。在本分析报告中,基于包括PubMed、EMBASE、科学网、谷歌学术、中国知网、万方数据和维普资讯在内的八个数据库,对ICI在LT后出现肝肿瘤复发或癌的受者中的临床应用及治疗效果进行了研究。并分析了LT后接受ICI治疗的恶性肿瘤患者的既往治疗、疾病反应、不良反应及预后情况。经过筛选,共纳入28篇关于LT后应用ICI的文章,涉及47名受者。在这些患者中,他们的中位年龄为57(14 - 71)岁,LT后主要肿瘤类型为HCC(59.6%)。ICI治疗后的总体缓解率为29.8%(14/47),疾病进展率为68.1%(32/47)。在所有这些患者中,31.9%(15/47)的患者出现免疫排斥反应;中位生存时间为6.5(0.3 - 48)个月,死亡率为61.7%(29/47)。鉴于ICI对LT后出现HCC复发或癌的受者治疗效果不理想,对于LT患者应谨慎考虑ICI治疗,且需要进一步研究。