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Efficacy of liver transplantation after response to atezolizumab-bevacizumab downstaging of intermediate and advanced hepatocellular carcinoma (ImmunoXXL) - PubMed

5 hours ago
  • #immunotherapy
  • #liver transplantation
  • #hepatocellular carcinoma
  • Liver transplantation (LT) efficacy after atezolizumab-bevacizumab (Atezo-Bev) downstaging in intermediate/advanced HCC.
  • Prospective phase II study with 16 HCC patients beyond extended transplant criteria.
  • Median tumor size: 6.5 cm; 50% had portal vein thrombosis; median AFP 283.
  • Downstaging to LT achieved after median 4.7 months of Atezo-Bev treatment.
  • Pre-transplant immune-related adverse events: 19%; post-transplant acute rejection: 25%.
  • 90-day post-LT morbidity: 62.5%; mortality: 6.3%.
  • Explant pathology: 10 complete responses, 6 partial responses.
  • Tumor microenvironment showed immune activation/extinguishment linked to treatment duration.
  • Post-LT HCC recurrence: 6.2%; 2-year RFS: 90%; overall survival: 94%.
  • LT after Atezo-Bev offers competitive outcomes for advanced HCC beyond standard criteria.