Mechanism, Potential, and Concerns of Immunotherapy for Hepatocellular Carcinoma and Liver Transplantation.

Bruno Sensi, Roberta Angelico, Luca Toti, Luigi Conte, Alessandro Coppola, Giuseppe Tisone, Tommaso Maria Manzia
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Abstract

In the last decade, immunotherapy (IT) has revolutionized oncology and found indications in many cancers, including hepatocellular carcinoma (HCC). In HCC, IT has become the leading systemic therapy for advanced diseases. At the same time, it carries the promise of being a valuable therapy in other settings, including intermediate-stage and unresectable disease, as a downstaging or conversion modality. More controversial is the role of IT in relationship to liver transplantation (LT): on one side, it could be a helpful tool to control or downstage HCC before LT or to treat tumor recurrence after LT, while on the other, it carries the risk of graft rejection and graft loss. This review aims to cover these concerns in depth and unravel the current literature.

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肝细胞癌和肝移植免疫疗法的机理、潜力和担忧。
近十年来,免疫疗法(IT)在肿瘤学领域掀起了一场革命,并在包括肝细胞癌(HCC)在内的多种癌症中找到了适应症。在肝细胞癌领域,免疫疗法已成为治疗晚期疾病的主要系统疗法。与此同时,在其他情况下,包括中晚期和无法切除的疾病,它也有望成为一种有价值的疗法,作为一种降期或转换模式。更具争议性的是 IT 在肝移植(LT)中的作用:一方面,它可能是在 LT 前控制或降低 HCC 分期或在 LT 后治疗肿瘤复发的有用工具,而另一方面,它又存在移植物排斥和移植物丢失的风险。本综述旨在深入探讨这些问题,并对现有文献进行解读。
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