Ipilumumab for hepatocellular cancer in a liver transplant recipient, with durable response, tolerance and without allograft rejection

Immunotherapy. 2020 Apr;12(5):287-292. doi: 10.2217/imt-2020-0014. Epub 2020 Apr 6.

Abstract

Organ transplant recipients are not routinely included in clinical trials, and as a result there is a paucity of data to guide clinicians in the treatment of malignancies in this unique patient population. This is a case report and focused review of the treatment of hepatocellular carcinoma in patients with orthotopic liver transplants. We describe a single patient's treatment over a period of 4 years from the time of diagnosis to submission of this case report. We submit evidence that the anti-CTLA-4 antibody ipilimumab can produce a durable response, with a tolerable adverse event profile and without associated allograft rejection.

Keywords: hepatocellular carcinoma; immune checkpoint inhibitor; ipilimumab; liver transplant.

MeSH terms

  • Carcinoma, Hepatocellular / drug therapy*
  • Female
  • Graft Survival
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immunotherapy / methods*
  • Ipilimumab / therapeutic use*
  • Liver Cirrhosis / surgery*
  • Liver Neoplasms / drug therapy*
  • Liver Transplantation*
  • Middle Aged
  • Monitoring, Physiologic
  • Remission Induction
  • Transplantation, Homologous
  • alpha-Fetoproteins / metabolism

Substances

  • Immune Checkpoint Inhibitors
  • Ipilimumab
  • alpha-Fetoproteins