Drug Ups Liver Cancer Patients' Survival After Transplant

Sirolimus-based immunosuppression linked to improved survival in hepatocellular carcinoma

MONDAY, April 19 (HealthDay News) -- In patients with hepatocellular carcinoma (HCC), sirolimus-based immunosuppression protocols are associated with significantly improved survival rates after liver transplantation, according to research published in the April issue of Hepatology.

Christian Toso, M.D., of the University of Alberta in Edmonton, Canada, and colleagues analyzed data from the Scientific Registry of Transplant Recipients on 2,491 adults who underwent liver transplantation for HCC, as well as 12,167 who received a transplant for non-HCC diagnoses. All stayed on stable maintenance immunosuppression protocols for at least six months.

The researchers found that, in the HCC group, sirolimus-based maintenance therapy and anti-CD25 antibody induction were linked to better survival after transplantation (hazard ratios, 0.53 and 0.64, respectively). Calcineurin inhibitors did not show a significant impact. In non-HCC patients, anti-CD25 induction was associated with a trend toward improved survival. However, sirolimus showed a trend toward lower rates of survival, pointing to a specific benefit in cancer patients.

"According to the present study, sirolimus-based immunosuppression is associated with improved patient survival after liver transplantation for HCC. Anti-CD25 antibody induction demonstrates a similar effect in patients transplanted for HCC and non-HCC diagnoses. We believe that these data will help in the transplant management of HCC patients, integrating a balanced selection of candidates with expected good outcomes and a post-transplant adjuvant treatment including appropriate and effective immunosuppression with anticancer properties," the authors conclude.

One author was supported by a CIHR/Wyeth Research Chair in Transplantation.

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