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Jones-Pauley M, Victor DW, Kodali S. Pushing the limits of treatment for hepatocellular carcinoma. Curr Opin Organ Transplant 2024; 29:3-9. [PMID: 38032256 DOI: 10.1097/mot.0000000000001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW We review existing and newer strategies for treatment and surveillance of hepatocellular carcinoma (HCC) both pre and postliver transplantation. SUMMARY HCC is rising in incidence and patients are often diagnosed at later stages. Consequently, there is a need for treatment strategies which include collaboration of multiple specialties. Combinations of locoregional, systemic, and surgical therapies are yielding better postliver transplantation (post-LT) outcomes for patients with HCC than previously seen. Tumor biology (tumor size, number, location, serum markers, response to therapy) can help identify patients who are at high risk for HCC recurrence posttransplantation and may expand transplant eligibility for some patients.
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Affiliation(s)
| | - David W Victor
- Division of Gastroenterology and Hepatology, Department of Medicine
- Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, Texas
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Sudha Kodali
- Division of Gastroenterology and Hepatology, Department of Medicine
- Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, Texas
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
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Tanimine N, Ohira M, Kurita E, Nakano R, Sakai H, Tahara H, Ide K, Kobayashi T, Tanaka Y, Ohdan H. Impact of KIR-HLA Genotype on Natural-Killer-Cell-Based Immunotherapy for Preventing Hepatocellular Carcinoma after Living-Donor Liver Transplantation. Cancers (Basel) 2024; 16:533. [PMID: 38339284 PMCID: PMC10854659 DOI: 10.3390/cancers16030533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Natural killer (NK) cells have immunosurveillance potential in hepatocellular carcinoma (HCC). We performed adaptive immunotherapy using donor-liver-derived natural killer (NK) cells after living-donor liver transplantation (LDLT) to prevent HCC recurrence. Dominant inhibitory signals tightly regulate NK cell activity via human leukocyte antigen (HLA)-specific inhibitory receptors, such as killer immunoglobulin-like receptors (KIRs). The functional recognition of HLA through KIR raises the NK cell capacity, which is a process termed "licensing." Here, we investigated the effect of polymorphic KIR-HLA genotypes on the efficacy of NK-cell-based immunotherapy after LDLT. Seventy-seven Japanese recipients with HCC who underwent LDLT and their corresponding donors between 1996 and 2016 were enrolled in this study. The median follow-up period was 8.3 years. The HCC recurrence risk was stratified using radiological and pathological assessments according to the Milan criteria. Of the 77 recipients, 38 received immunotherapy. Immunotherapy improves early post-transplantation survival and lowers the recurrence rate in the intermediate-risk recipients. We analyzed the genotypes of five inhibitory KIRs and HLA using sequence-specific polymorphism-based typing. The polymorphic KIR-HLA genotype revealed that genetically vulnerable liver transplant recipients with a poorly licensed NK genotype have an improved prognosis by immunotherapy with donor-liver-derived NK cells. Thus, the combination of recipient and donor KIR-HLA genotypes is worthy of attention for further investigation, especially considering the clinical application of NK-cell-based immunotherapy.
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Affiliation(s)
- Naoki Tanimine
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
- Department of Surgery, Kure Medical Center, Chugoku Cancer Center, 3-1 Aoyama-cho, Kure 737-0023, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
| | - Emi Kurita
- Division of Blood Transfusion Services, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan;
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
| | - Kentaro Ide
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
| | - Yuka Tanaka
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
| | - Hideki Ohdan
- Department of Gastroenterological and Transplantation Surgery, Graduates School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan; (N.T.); (M.O.); (R.N.); (H.S.); (H.T.); (K.I.); (T.K.); (Y.T.)
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