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Article: Mammalian target of rapamycin inhibitors after post-transplant hepatocellular carcinoma recurrence: Is it too late?
Title | Mammalian target of rapamycin inhibitors after post-transplant hepatocellular carcinoma recurrence: Is it too late? |
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Authors | |
Keywords | Mammalian target of rapamycin inhibitor Hepatocellular carcinoma Recurrence Liver transplant Survival |
Issue Date | 2020 |
Publisher | Baishideng Publishing Group Co., Limited. The Journal's web site is located at https://www.wjgnet.com/1948-9366/index.htm |
Citation | World Journal of Gastrointestinal Surgery, 2020, v. 12 n. 4, p. 149-158 How to Cite? |
Abstract | BACKGROUND
Mammalian target of rapamycin (mTOR) inhibitors have been shown to reduce the risk of tumour recurrence after liver transplantation for hepatocellular carcinoma (HCC). However, their role in established post-transplant HCC recurrence is uncertain.
AIM
To investigate whether mTOR inhibitor offers a survival benefit in post-transplant HCC recurrence.
METHODS
A retrospective study of 143 patients who developed HCC recurrence after liver transplantation was performed. They were divided into 2 groups based on whether they had received mTOR inhibitor-based immunosuppression. The primary endpoint was post-recurrence survival.
RESULTS
Seventy-nine (55%) patients received an mTOR inhibitor-based immunosuppressive regime, while 64 (45%) patients did not. The mTOR inhibitor group had a lower number of recurrent tumours (2 vs 5, P = 0.02) and received more active treatments including radiotherapy (39 vs 22%, P = 0.03) and targeted therapy (59 vs 23%, P < 0.001). The median post-recurrence survival was 21.0 ± 4.1 mo in the mTOR inhibitor group and 11.2 ± 2.5 mo in the control group. Multivariate Cox regression analysis confirmed that mTOR inhibitor therapy was independently associated with improved post-recurrence survival (P = 0.04, OR = 0.482, 95%CI: 0.241-0.966). The number of recurrent tumours and use of other treatment modalities did not affect survival. No survival difference was observed between mTOR inhibitor monotherapy and combination therapy with calcineurin inhibitor.
CONCLUSION
mTOR inhibitors prolonged survival after post-transplant HCC recurrence. |
Persistent Identifier | http://hdl.handle.net/10722/305056 |
ISSN | 2023 Impact Factor: 1.8 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Au, KP | - |
dc.contributor.author | Chok, KSH | - |
dc.date.accessioned | 2021-10-05T02:39:07Z | - |
dc.date.available | 2021-10-05T02:39:07Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | World Journal of Gastrointestinal Surgery, 2020, v. 12 n. 4, p. 149-158 | - |
dc.identifier.issn | 1948-9366 | - |
dc.identifier.uri | http://hdl.handle.net/10722/305056 | - |
dc.description.abstract | BACKGROUND Mammalian target of rapamycin (mTOR) inhibitors have been shown to reduce the risk of tumour recurrence after liver transplantation for hepatocellular carcinoma (HCC). However, their role in established post-transplant HCC recurrence is uncertain. AIM To investigate whether mTOR inhibitor offers a survival benefit in post-transplant HCC recurrence. METHODS A retrospective study of 143 patients who developed HCC recurrence after liver transplantation was performed. They were divided into 2 groups based on whether they had received mTOR inhibitor-based immunosuppression. The primary endpoint was post-recurrence survival. RESULTS Seventy-nine (55%) patients received an mTOR inhibitor-based immunosuppressive regime, while 64 (45%) patients did not. The mTOR inhibitor group had a lower number of recurrent tumours (2 vs 5, P = 0.02) and received more active treatments including radiotherapy (39 vs 22%, P = 0.03) and targeted therapy (59 vs 23%, P < 0.001). The median post-recurrence survival was 21.0 ± 4.1 mo in the mTOR inhibitor group and 11.2 ± 2.5 mo in the control group. Multivariate Cox regression analysis confirmed that mTOR inhibitor therapy was independently associated with improved post-recurrence survival (P = 0.04, OR = 0.482, 95%CI: 0.241-0.966). The number of recurrent tumours and use of other treatment modalities did not affect survival. No survival difference was observed between mTOR inhibitor monotherapy and combination therapy with calcineurin inhibitor. CONCLUSION mTOR inhibitors prolonged survival after post-transplant HCC recurrence. | - |
dc.language | eng | - |
dc.publisher | Baishideng Publishing Group Co., Limited. The Journal's web site is located at https://www.wjgnet.com/1948-9366/index.htm | - |
dc.relation.ispartof | World Journal of Gastrointestinal Surgery | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Mammalian target of rapamycin inhibitor | - |
dc.subject | Hepatocellular carcinoma | - |
dc.subject | Recurrence | - |
dc.subject | Liver transplant | - |
dc.subject | Survival | - |
dc.title | Mammalian target of rapamycin inhibitors after post-transplant hepatocellular carcinoma recurrence: Is it too late? | - |
dc.type | Article | - |
dc.identifier.email | Chok, KSH: chok6275@hku.hk | - |
dc.identifier.authority | Chok, KSH=rp02110 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.4240/wjgs.v12.i4.149 | - |
dc.identifier.pmid | 32426094 | - |
dc.identifier.pmcid | PMC7215969 | - |
dc.identifier.hkuros | 326512 | - |
dc.identifier.volume | 12 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 149 | - |
dc.identifier.epage | 158 | - |
dc.identifier.isi | WOS:000536284500003 | - |
dc.publisher.place | United States | - |