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PD-1抑制剂用于肝癌肝移植术前治疗的安全性探讨

刘召波 武聚山 林栋栋 栗光明

刘召波, 武聚山, 林栋栋, 等. PD-1抑制剂用于肝癌肝移植术前治疗的安全性探讨[J]. 器官移植, 2021, 12(4): 445-449. doi: 10.3969/j.issn.1674-7445.2021.04.011
引用本文: 刘召波, 武聚山, 林栋栋, 等. PD-1抑制剂用于肝癌肝移植术前治疗的安全性探讨[J]. 器官移植, 2021, 12(4): 445-449. doi: 10.3969/j.issn.1674-7445.2021.04.011
Liu Zhaobo, Wu Jushan, Lin Dongdong, et al. Safety of PD-1 inhibitor in preoperative treatment of liver transplantation for liver cancer[J]. ORGAN TRANSPLANTATION, 2021, 12(4): 445-449. doi: 10.3969/j.issn.1674-7445.2021.04.011
Citation: Liu Zhaobo, Wu Jushan, Lin Dongdong, et al. Safety of PD-1 inhibitor in preoperative treatment of liver transplantation for liver cancer[J]. ORGAN TRANSPLANTATION, 2021, 12(4): 445-449. doi: 10.3969/j.issn.1674-7445.2021.04.011

PD-1抑制剂用于肝癌肝移植术前治疗的安全性探讨

doi: 10.3969/j.issn.1674-7445.2021.04.011
基金项目: 

北京医卫健康公益基金会医学科学研究基金 LC19003

北京市医院管理中心重点医学专业发展计划——肝脏外科专业 ZYLX202124

详细信息
    作者简介:

    刘召波,男,1982年生,硕士,副主任医师,研究方向为肝移植、肝癌,Email:liuzhaobo@ccmu.edu.cn

    通讯作者:

    林栋栋,男,1971年生,博士,主任医师,研究方向为肝移植、肝癌,Email:ldd1231@ccmu.edu.cn

    栗光明,男,1967年生,硕士,主任医师,研究方向为肝移植、肝癌,Email:liguangming@ccmu.edu.cn

  • 中图分类号: R617, R575

Safety of PD-1 inhibitor in preoperative treatment of liver transplantation for liver cancer

More Information
  • 摘要:   目的  探讨程序性细胞死亡蛋白1(PD-1)抑制剂用于原发性肝癌(肝癌)肝移植术前治疗的安全性。  方法  回顾性分析7例术前应用PD-1抑制剂的肝癌肝移植受者的临床资料,总结受者免疫相关不良反应(irAE)发生情况及预后情况,评估PD-1抑制剂在肝癌肝移植受者中使用的安全性。  结果  7例肝癌肝移植受者术前使用PD-1抑制剂,使用疗程为1~20个,自停药至手术间隔时间为6~120 d。5例受者发生不同程度的irAE,其中疲乏3例、发热2例、脱发2例、皮疹2例、腹泻1例、恶心1例、心肌炎1例,多数irAE毒性分级为G1~2级,1例发生G5级毒性反应(致死性心肌炎),并导致受者死亡。1例受者于术后7 d发生排斥反应,经糖皮质激素冲击治疗及增加他克莫司剂量后好转。  结论  PD-1抑制剂可用于肝癌肝移植术前治疗,但应密切注意其irAE及术后排斥反应的发生。

     

  • 表  1  7例肝癌肝移植受者的临床资料

    Table  1.   Clinical data of 7 recipients after liver transplantation for liver cancer

    例序 年龄(岁) PD-1抑制剂 药物剂量(mg) 使用疗程(个) 停药至手术间隔(d) 桥接/降期治疗 靶向治疗 术后免疫抑制方案 术后免疫诱导 不良反应 毒性分级 排斥反应 预后
    1 60 帕博利珠单抗 100 5 12 TACE+肝癌切除+放疗 索拉非尼序贯仑伐替尼 三联 腹泻、皮疹、脱发、疲乏 G1~2级 存活
    2 50 卡瑞利珠单抗 200 1 18 仑伐替尼 三联 发热 G1~2级 存活
    3 49 信迪利单抗 100 4 120 TACE+肝癌切除 仑伐替尼 三联 脱发、恶心、疲乏 G1~2级 存活
    4 56 信迪利单抗+纳武单抗 100 2 18 仑伐替尼 三联 发热、皮疹、疲乏 G1~2级 存活
    5 56 纳武单抗 100 5 6 肝癌切除+TACE 仑伐替尼 三联 心肌炎 G5级 死亡
    6 55 信迪利单抗 100 20 36 TACE 仑伐替尼 二联 存活
    7 60 卡瑞利珠单抗 200 5 10 索拉非尼 二联 存活
    下载: 导出CSV
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  • 收稿日期:  2021-03-26
  • 刊出日期:  2021-07-15

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