1
|
Su RY, Ling SB, Shan QN, Wei XY, Wang R, Jia CK, Zhuang L, Shen T, Ding LM, Xu ZD, Luo LB, Sun LB, Li GM, Fang TS, Jiang N, Zhang K, Su ZJ, Peng ZH, Lang R, Jiang T, He Q, Ye LS, Yang Y, He YT, Guo WZ, Lan LG, Sun XY, Chen D, Chen ZS, Zhou DW, Ye SJ, Ye QF, Tian M, Shi JH, Wang B, Liu J, Lu Q, Rao W, Cai JZ, Lv T, Yang JY, Wang PS, Zhong L, Ma JS, Li QG, Wu SD, Lu CJ, Lu CD, Zhang DH, Wang X, Li ZQ, Teng MJ, Li JJ, Jiang WT, Li JH, Zhang QB, Zhu NQ, Wang ZX, He K, Xia Q, Song SH, Fu ZR, Qiu W, Lv GY, Song RP, Wang JZ, Wang Z, Zhou J, Chen G, Zhao YP, Li L, Hu ZM, Luo QJ, Si ZZ, Xie B, He XS, Guo ZY, Zheng SS, Xu X. Efficacy and safety of sirolimus early conversion protocol in liver transplant patients with hepatocellular carcinoma: A single-arm, multicenter, prospective study. Hepatobiliary Pancreat Dis Int 2022; 21:106-112. [PMID: 34583911 DOI: 10.1016/j.hbpd.2021.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/31/2021] [Indexed: 02/05/2023]
Abstract
Mammalian target of rapamycin (mTOR) inhibitor as an attractive drug target with promising antitumor effects has been widely investigated. High quality clinical trial has been conducted in liver transplant (LT) recipients in Western countries. However, the pertinent studies in Eastern world are paucity. Therefore, we designed a clinical trial to test whether sirolimus can improve recurrence-free survival (RFS) in hepatocellular carcinoma (HCC) patients beyond the Milan criteria after LT. This is an open-labeled, single-arm, prospective, multicenter, and real-world study aiming to evaluate the clinical outcomes of early switch to sirolimus-based regimens in HCC patients after LT. Patients with a histologically proven HCC and beyond the Milan criteria will be enrolled. The initial immunosuppressant regimens are center-specific for the first 4-6 weeks. The following regimens integrated sirolimus into the regimens as a combination therapy with reduced calcineurin inhibitors based on the condition of patients and centers. The study is planned for 4 years in total with a 2-year enrollment period and a 2-year follow-up. We predict that sirolimus conversion regimen will provide survival benefits for patients particular in the key indicator RFS as well as better quality of life. If the trial is conducted successfully, we will have a continued monitoring over a longer follow-up time to estimate indicator of overall survival. We hope that the outcome will provide better evidence for clinical decision-making and revising treatment guidelines based on Chinese population data. Trial register: Trial registered at http://www.chictr.org.cn: ChiCTR2100042869.
Collapse
Affiliation(s)
- Ren-Yi Su
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Sun-Bin Ling
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Qiao-Nan Shan
- NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou 310003, China
| | - Xu-Yong Wei
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Rui Wang
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Chang-Ku Jia
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Li Zhuang
- Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Zhejiang Shuren University School of Medicine, Hangzhou 310022, China
| | - Tian Shen
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Li-Min Ding
- Department of Transplantation, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, China
| | - Zhi-Dan Xu
- Department of Transplantation, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, China
| | - Lai-Bang Luo
- Department of Transplantation, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, China
| | - Li-Bo Sun
- Liver Transplantation Center, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Guang-Ming Li
- Liver Transplantation Center, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Tai-Shi Fang
- Department of Hepatic Surgery, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen 518112, China
| | - Nan Jiang
- Department of Hepatic Surgery, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen 518112, China
| | - Kun Zhang
- Department of General Surgery, Xiang'an Hospital of Xiamen University, Xiamen 361000, China
| | - Zhao-Jie Su
- Department of General Surgery, Xiang'an Hospital of Xiamen University, Xiamen 361000, China
| | - Zhi-Hai Peng
- Department of General Surgery, Xiang'an Hospital of Xiamen University, Xiamen 361000, China
| | - Ren Lang
- Deartment of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Tao Jiang
- Deartment of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Qiang He
- Deartment of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Lin-Sen Ye
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Yang Yang
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Yu-Ting He
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Wen-Zhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Liu-Gen Lan
- Department of Liver Transplantation, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - Xu-Yong Sun
- Department of Liver Transplantation, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - Dong Chen
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhi-Shui Chen
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Da-Wei Zhou
- Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Shao-Jun Ye
- Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Qi-Fa Ye
- Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Min Tian
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Jian-Hua Shi
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Bo Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Jiang Liu
- Liver Transplantation Center, Tsinghua Changgung Hospital, Beijing 102218, China
| | - Qian Lu
- Liver Transplantation Center, Tsinghua Changgung Hospital, Beijing 102218, China
| | - Wei Rao
- Organ Transplantation Center, Affiliated Hospital of Qingdao University, 59 Haier Road, Laoshan District, Qingdao 266061, China
| | - Jin-Zhen Cai
- Organ Transplantation Center, Affiliated Hospital of Qingdao University, 59 Haier Road, Laoshan District, Qingdao 266061, China
| | - Tao Lv
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610044, China
| | - Jia-Yin Yang
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610044, China
| | - Pu-Sen Wang
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Lin Zhong
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Jing-Sheng Ma
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Qi-Gen Li
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Sheng-Dong Wu
- Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo 315041, China
| | - Chang-Jiang Lu
- Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo 315041, China
| | - Cai-De Lu
- Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo 315041, China
| | - Dong-Hua Zhang
- Liver Transplant Center, General Hospital of Eastern Theater Command, Nanjing 210002, China
| | - Xuan Wang
- Liver Transplant Center, General Hospital of Eastern Theater Command, Nanjing 210002, China
| | - Zi-Qiang Li
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, China
| | - Mu-Jian Teng
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, China
| | - Jun-Jie Li
- Liver Transplant Department, Tianjin First Center Hospital, Tianjin 300192, China
| | - Wen-Tao Jiang
- Liver Transplant Department, Tianjin First Center Hospital, Tianjin 300192, China
| | - Jian-Hua Li
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Quan-Bao Zhang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ning-Qi Zhu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zheng-Xin Wang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Kang He
- Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Qiang Xia
- Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Shao-Hua Song
- Liver Transplantaiton Center, Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zhi-Ren Fu
- Liver Transplantaiton Center, Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Wei Qiu
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun 130021, China
| | - Guo-Yue Lv
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun 130021, China
| | - Rui-Peng Song
- Department of Hepatobiliary Surgery, Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of USTC; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Ji-Zhou Wang
- Department of Hepatobiliary Surgery, Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of USTC; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Zheng Wang
- Department of Liver Surgery & Transplantation, Zhongshan Hospital Fudan University, Shanghai 200032, China
| | - Jian Zhou
- Department of Liver Surgery & Transplantation, Zhongshan Hospital Fudan University, Shanghai 200032, China
| | - Gang Chen
- Department of hepato-biliary-pancreatic surgery and liver transplantation center, the First People' s Hospital of Kunming, Kunming 650000, China
| | - Ying-Peng Zhao
- Department of hepato-biliary-pancreatic surgery and liver transplantation center, the First People' s Hospital of Kunming, Kunming 650000, China
| | - Li Li
- Department of hepato-biliary-pancreatic surgery and liver transplantation center, the First People' s Hospital of Kunming, Kunming 650000, China
| | - Ze-Min Hu
- Department of Hepatobiliary Surgery, Zhongshan City People's Hospital, Zhongshan 528499, China
| | - Qi-Jie Luo
- Department of Hepatobiliary Surgery, Zhongshan City People's Hospital, Zhongshan 528499, China
| | - Zhong-Zhou Si
- Department of Liver Transplantation Center, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Bin Xie
- Department of Liver Transplantation Center, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Xiao-Shun He
- Department of Hepatic Surgery and Liver Transplantation Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - Zhi-Yong Guo
- Department of Hepatic Surgery and Liver Transplantation Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - Shu-Sen Zheng
- NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou 310003, China; Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Zhejiang Shuren University School of Medicine, Hangzhou 310022, China; Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
| | - Xiao Xu
- Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou 310003, China; Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
| |
Collapse
|