Ann Liver Transplant.  2023 Nov;3(2):104-112. 10.52604/alt.23.0022.

Sequential regorafenib or nivolumab therapy in recurrent hepatocellular carcinoma with sorafenib failure in liver transplant patients does not improve prognosis

• Kwon J
• Kim J
• Rhu J
• Choi GS
• Joh JW

• KMID: 2560931
• DOI: http://doi.org/10.52604/alt.23.0022

Abstract

Background
Systemic treatment options for hepatocellular carcinoma (HCC) after liver transplantation (LT) are limited in patients in whom sorafenib treatment was failed. The purpose of our study was to compare outcomes among sorafenib, regorafenib, and nivolumab treatment groups in patients with recurrent HCC after LT.
Methods
This study retrospectively evaluated patients who received sorafenib for recurrent HCC treatment after LT at a single center from March 2007 to December 2018. Some patients received regorafenib or nivolumab after sorafenib treatment failure.
Results
Fifty-six patients were treated with sorafenib due to HCC recurrence. Among these, 38 patients (67.9%) continued treatment with sorafenib only; the other 18 patients (32.1%) were converted to regorafenib treatment. Ten patients of these 18 were converted to nivolumab after sorafenib and regorafenib therapy failed. The disease-free survival and overall survival (OS) from LT were not different among the three groups. In addition, OS from HCC recurrence, sorafenib usage, and usage of each systemic therapeutic agent were not different among the three groups. Three cases in the nivolumab group developed acute rejection; one of these led to graft failure and death due to antibody-mediated rejection.
Conclusion
Sequential regorafenib or nivolumab treatment in recurrent HCC LT patients does not improve OS compared sorafenib treatment.

Keyword

Graft rejection; Survival; Mortality; Drug therapy

Figure

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  Figure 1 Survival from liver transplantation. (A) Disease-free survival and (B) overall survival. HCC, hepatocellular carcinoma.

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  Figure 2 Overall survival after HCC recurrence (A), with sorafenib use (B), and with each systemic chemotherapeutic agent (C). HCC, hepatocellular carcinoma.

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