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Use immunotherapy to shrink liver cancer enough for a transplant, and find the safe gap between the last dose and surgery so the new liver is not rejected.
The idea is to use checkpoint inhibitors such as nivolumab or atezolizumab to shrink hepatocellular carcinoma enough for liver transplantation, and to define the safe gap between the last dose and surgery so the new liver is not rejected. Checkpoint inhibitors persist on T cells for months, so the risk is time-dependent and measurable; case series report rejection when PD-1 antibodies are given within weeks of transplant, others successful downstaging. The hypothesis is that a washout of at least three months, timed by receptor occupancy or ctDNA, allows safe transplantation with recurrence-free survival equal to conventionally downstaged patients. The test is a prospective single-arm trial with protocolised washout and biopsy-proven rejection as the safety endpoint.
One of the most cited trial reports Europe PMC returns for Atezolizumab in Hepatocellular carcinoma, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
One idea page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Patients with advanced liver cancer and good liver function should be offered atezolizumab plus bevacizumab (or durvalumab plus tremelimumab) rather than sorafenib as first treatment; median survival is now around 19 months and about a quarter of patients respond. Endoscopy to treat varices before starting bevacizumab is essential because of bleeding risk. Patients with poorer liver function (Child-Pugh B) or autoimmune disease or transplants were not studied.
One of the most cited trial reports Europe PMC returns for Nivolumab in Hepatocellular carcinoma, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
Shares IMbrave050, IMbrave150, IMbrave150: atezolizumab plus bevacizumab replaces sorafenib as first treatment for advanced liver cancer, Atezolizumab.
Shares IMbrave150, IMbrave150: atezolizumab plus bevacizumab replaces sorafenib as first treatment for advanced liver cancer, Atezolizumab, Hepatocellular carcinoma.
Shares IMbrave150, IMbrave150: atezolizumab plus bevacizumab replaces sorafenib as first treatment for advanced liver cancer, Atezolizumab, Hepatocellular carcinoma.
Shares IMbrave050, Early hepatocellular carcinoma (BCLC 0 and A), Atezolizumab.
Shares Early hepatocellular carcinoma (BCLC 0 and A), Nivolumab, Hepatocellular carcinoma, Immune checkpoint inhibitors.
Shares IMbrave150, Atezolizumab, Hepatocellular carcinoma.
Shares Early hepatocellular carcinoma (BCLC 0 and A), Hepatocellular carcinoma, Immune checkpoint inhibitors.
Shares Early hepatocellular carcinoma (BCLC 0 and A), Hepatocellular carcinoma, Immune checkpoint inhibitors.