Saleh, Y.; Abu Hejleh, T.; Abdelrahim, M.; Shamseddine, A.; Chehade, L.; Alawabdeh, T.; Mohamad, I.; Sammour, M.; Turfa, R. Hepatocellular Carcinoma: The Evolving Role of Systemic Therapies as a Bridging Treatment to Liver Transplantation. Cancers2024, 16, 2081.
Saleh, Y.; Abu Hejleh, T.; Abdelrahim, M.; Shamseddine, A.; Chehade, L.; Alawabdeh, T.; Mohamad, I.; Sammour, M.; Turfa, R. Hepatocellular Carcinoma: The Evolving Role of Systemic Therapies as a Bridging Treatment to Liver Transplantation. Cancers 2024, 16, 2081.
Saleh, Y.; Abu Hejleh, T.; Abdelrahim, M.; Shamseddine, A.; Chehade, L.; Alawabdeh, T.; Mohamad, I.; Sammour, M.; Turfa, R. Hepatocellular Carcinoma: The Evolving Role of Systemic Therapies as a Bridging Treatment to Liver Transplantation. Cancers2024, 16, 2081.
Saleh, Y.; Abu Hejleh, T.; Abdelrahim, M.; Shamseddine, A.; Chehade, L.; Alawabdeh, T.; Mohamad, I.; Sammour, M.; Turfa, R. Hepatocellular Carcinoma: The Evolving Role of Systemic Therapies as a Bridging Treatment to Liver Transplantation. Cancers 2024, 16, 2081.
Abstract
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths. Classically, liver transplantation (LT) can be curable for HCC tumors within the Milan criteria. Bridging strategies to reduce the dropouts from LT waiting lists or/and to downstage patients who are beyond Milan criteria are widely utilized. We conducted a literature-based review to evaluate the role of systemic therapies as a bridging treatment to liver transplantation (LT) in HCC patients. Tyrosine Kinase Inhibitors (TKIs) can be used as a bridging systemic therapy to LT in patients with contraindication to locoregional liver-directed therapies. Immune Checkpoint Inhibitors (ICIs) treatment can be utilized either as a monotherapy or as a combination therapy with Bevacizumab or TKIs prior to LT. Acute rejection post liver transplantation is a concern in the context of ICIs treatment. Thus, a safe ICI washout period before LT and cautious post-LT immunosuppression strategies are required to reduce post-LT rejections and to optimize clinical outcomes. Nevertheless, prospective clinical trials are needed to establish definitive conclusions about the utility of systemic therapy as a bridging modality prior to LT in HCC patients.
Medicine and Pharmacology, Oncology and Oncogenics
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