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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Nov 28, 2020; 10(11): 297-306
Published online Nov 28, 2020. doi: 10.5500/wjt.v10.i11.297
Published online Nov 28, 2020. doi: 10.5500/wjt.v10.i11.297
Lenvatinib as first-line therapy for recurrent hepatocellular carcinoma after liver transplantation: Is the current evidence applicable to these patients?
Federico Piñero, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Buenos Aires B1629HJ, Argentina
Federico Piñero, Marcos Thompson, Marcelo Silva, Hospital Universitario Austral, Facultad de Ciencias Biomédicas, Universidad Austral, Buenos Aires B1629HJ, Argentina
Federico Piñero, Marcelo Silva, Latin American Liver Research Educational and Awareness Network (LALREAN), Buenos Aires B1629HJ, Argentina
Juan Ignacio Marín, Hepatology and Liver Transplantation Unit, Hospital Pablo Tobón Uribe, Medellín 240, Colombia
Author contributions: All authors contributed equally to this paper in conception and design of the study, literature review, drafting, critical revision and editing. All authors have approved the final version.
Conflict-of-interest statement: Piñero F has received Advisory Board and speaker honoraria and he is a consultant for RAFFO, BAYER Cono Sur and BAYER Andina; research grants from the Argentinean National Institute of Cancer (INC ID-190), Argentinean National Ministry of Science and Technology Development (PICT 2017, FONCYT) and from the Latin American Liver Research Educational and Awareness Network (LALREAN). Marin J has received Advisory Board and speaker honoraria from BAYER and GILEAD. Silva M has received speaker honoraria and is a consultant for Abvie, Gador, Bristol-Myers Squibb, Merck, BAYER and has received research grants from the Argentinean National Institute of Cancer (INC ID-190), and the Argentinean National Ministry of Science and Technology Development (PICT 2017, FONCYT).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Federico Piñero, MD, MSc, Academic Research, Doctor, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Av. Presidente Perón 1500, Pilar, Buenos Aires B1629HJ, Argentina. fpinerof@cas.austral.edu.ar
Received: May 18, 2020
Peer-review started: May 18, 2020
First decision: June 3, 2020
Revised: June 9, 2020
Accepted: September 22, 2020
Article in press: September 22, 2020
Published online: November 28, 2020
Peer-review started: May 18, 2020
First decision: June 3, 2020
Revised: June 9, 2020
Accepted: September 22, 2020
Article in press: September 22, 2020
Published online: November 28, 2020
Core Tip
Core Tip: Post-transplant hepatocellular carcinoma (HCC) recurrence is a significant negative predictor of survival. There is no consensus on the treatment of recurrence. If possible, resection should be attempted. The use of systemic chemotherapy after transplant is limited to small retrospective cohort studies. Immunotherapy with checkpoint inhibitors in the post-transplant setting is challenging due to the potentially increased risk of allograft rejection. This opinion review illustrates a late post-transplant HCC recurrence treated with lenvatinib, with good tolerance and overall survival after lung and adrenal metastasis resections in a patient previously intolerant to sorafenib.