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Downstaging of hepatocellular carcinoma before liver transplantation: Results from a national multi-center prospective cohort study.
Hepatology
January 2025
Division of Gastroenterology and Hepatology, University of California, San Francisco, San Francisco, CA.
Background Aims: Patients with hepatocellular carcinoma (HCC) meeting UNOS-downstaging (DS) criteria have excellent post-liver transplantation (LT) outcomes. Studies on HCC beyond UNOS-DS criteria ("All-comers" (AC)) have been limited by small sample size and short follow-up time, prompting this analysis.
Approach Results: 326 patients meeting UNOS-DS and 190 meeting AC criteria from 9 LT centers across 5 UNOS regions were enrolled from 2015 to 2023 and prospectively followed.
Transarterial therapy combined with bevacizumab plus immune checkpoint inhibitors as a neoadjuvant therapy for locally advanced HCC.
Front Immunol
January 2025
Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
Background: Transarterial therapy (TAT), bevacizumab (Bev), and immune checkpoint inhibitors (ICIs) have individually exhibited efficacy in treating advanced-stage hepatocellular carcinoma (HCC). This study aimed to assess the efficacy and safety of the combination of these three treatments as a neoadjuvant modality in patients with locally advanced HCC.
Methods: The primary endpoint is overall survival (OS).
Surgical resection versus thermal ablation: comparison of sequential options after successful TACE downstaging therapy for unresectable hepatocellular carcinoma.
Ther Adv Med Oncol
January 2025
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Minimal Invasive Intervention, Sun Yat-sen University Cancer Center, 651, Dongfeng East Road, Guangzhou 510060, P.R. China.
Background: Transarterial chemoembolization (TACE) is an effective and safe downstaging therapy for hepatocellular carcinoma (HCC). However, the selection of sequential therapeutic modalities is still controversial.
Objectives: This study compared the effectiveness and safety of surgical resection (SR) and thermal ablation (TA) after patients with HCC underwent TACE downstaging therapy.
Liver resection and transplantation in the era of checkpoint inhibitors.
JHEP Rep
November 2024
Department of Hepato-pancreato-Biliary and Transplant Surgery, National Cancer Center Singapore and Singapore General Hospital, Singapore.
Immune checkpoint inhibitors (ICIs) have revolutionised the treatment landscape for advanced hepatocellular carcinoma (HCC). The combination of atezolizumab and bevacizumab has demonstrated efficacy, establishing a new standard of care for advanced HCC. Neoadjuvant studies have shown promising results with high response rates, increasing research into ICIs' role.
View Article and Find Full Text PDFLiver Transplantation for Hepatocellular Carcinoma: An Expanding Cornerstone of Care in the Era of Immunotherapy.
J Clin Oncol
December 2024
HPB Surgical Oncology, University Health Network, Toronto, ON, Canada.
Liver transplantation (LT) has been accepted as a cornerstone of care in hepatocellular carcinoma (HCC) for almost three decades. In recent years, its role has been evolving to include patients with disease burden beyond the widely used Milan criteria. The integration of dynamic biomarkers such as alpha-fetoprotein together with downstaging approaches and tumor evolution after enlistment has allowed the selection of patients most likely to benefit, resulting in 5-year survival rates greater that 70%.
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