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mTOR Inhibition Is ...
mTOR Inhibition Is Most Beneficial After Liver Transplantation for Hepatocellular Carcinoma in Patients With Active Tumors
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- Schnitzbauer, Andreas A. (författare)
- Univ Klinikum Frankfurt, Klin Allgemein Viszeral & Transplantat Chirurg, Frankfurt, Germany.
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- Filmann, Natalie (författare)
- Univ Klinikum Frankfurt, Inst Biostat & Math Modellierung, Frankfurt, Germany.
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- Adam, Rene (författare)
- Hop Paul Brousse, Ctr Hepato Biliaire, Paris, France.
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- Bachellier, Philippe (författare)
- Hop Univ Strasbourg, Hop Hautepierre, Serv Chirurg Gen Hepat Endocrinienne & Transplant, Strasbourg, France.
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- Bechstein, Wolf O. (författare)
- Univ Klinikum Frankfurt, Klin Allgemein Viszeral & Transplantat Chirurg, Frankfurt, Germany.
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- Becker, Thomas (författare)
- Univ Klinikum Schleswig Holstein, Klin Allgemeine Chirurg Viszeral Thorax Transplan, Campus Kiel, Kiel, Germany.
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- Bhoori, Sherrie (författare)
- Fdn IRCCS Ist Nazl Tumori, Natl Canc Inst Milan, Dept Surg Transplantat & Hepatobiliary, Canc Unit, Milan, Italy.
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- Bilbao, Itxarone (författare)
- Hosp Univ Vall dHebron, Serv Cirugia Gen, Unidad Trasplante Hepat, Barcelona, Spain.
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- Brockmann, Jens (författare)
- Unive Klinikum Munster, Klin Allgemein & Viszeralchirurg, Munster, Germany.
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- Burra, Patrizia (författare)
- Univ Padua, Dipartimento Sci Chirurg Oncol & Gastroenterol Di, Padua, Italy.
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- Chazoullieres, Olivier (författare)
- Hop St Antoine, Federat Hepatogastroenterol, Serv Hepatol, Paris, France.
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- Cillo, Umberto (författare)
- Univ Padua, Azienda Osped Padova, Chirurg Epatobiliare & Trapianto Epat, Padua, Italy.
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- Colledan, Michele (författare)
- Azienda Osped Papa Giovanni XXIII, Chirurg Terza & Chirurg Torac, Bergamo, BG, Italy.
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- Duvoux, Christoph (författare)
- Univ Paris Est Creteil Val de Marne, Ctr Hosp Univ Henri Mondor, Serv Hepatol & Gastroenterol, Unite Hepat & Transplantat Hepat, Paris, France.
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- Ganten, Tom M. (författare)
- Univ Klinikum Heidelberg, Furst Stirum Klin Bruchsal, Bruchsal, Germany.
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- Gugenheim, Jean (författare)
- Ctr Hosp Univ Nice, Hop ARCHET 2, Serv Chirurg Digest, Ctr Transplantat Hepat, Nice, France.
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- Heise, Michael (författare)
- Univ Klinikum Frankfurt, Klin Allgemein Viszeral & Transplantat Chirurg, Frankfurt, Germany.
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- van Hoek, Bart (författare)
- Leiden Univ Med Ctr LUMC, Dept Gastroenterol & Hepatol, Leiden, Netherlands.
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- Jamieson, Neville (författare)
- CambridgeUnivers Hosp NHS Fdn Trust, Addenbrookes Hosp, Hills Rd, Cambridge, England.
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- de Jong, Koert P. (författare)
- Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Div Hepatopancreat Biliary Surg & Liver Transplan, Groningen, Netherlands.
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- Klein, Christian G. (författare)
- Univ Klinikum Essen, Klin Allgemein Viszeral & Transplantat Chirurg, Essen, Germany.
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- Klempnauer, Jurgen (författare)
- Hannover Med Sch, Klin Allgemein Viszeral & Transplantat Chirurg, Hannover, Germany.
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- Kneteman, Norman (författare)
- Univ Alberta, Alberta Hlth Serv Liver Transplant Program, Edmonton, AB, Canada.
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- Lerut, Jan (författare)
- Univ Catholique Louvain UCL, Inst Expt & Clin Res IREC, Brussels, Belgium.
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- Makisalo, Heikki (författare)
- Helsinki Univ Cent Hosp, Div Transplantat & Liver Surg, Helsinki, Finland.
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- Mazzaferro, Vincenzo (författare)
- Fdn IRCCS Ist Nazl Tumori, Natl Canc Inst Milan, Dept Surg Transplantat & Hepatobiliary, Canc Unit, Milan, Italy.
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- Mirza, Darius F. (författare)
- Queen Elizabeth Hosp, NHS Fdn Trust, Univ Hosp Birmingham, Liver & Hepatopancreatobiliary HPB Unit, Birmingham, W Midlands, England.
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- Nadalin, Silvio (författare)
- Univ Klinikum Tubingen, Klin Allgemeine Viszeral & Transplantat Chirurg, Tubingen, Germany.
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- Neuhaus, Peter (författare)
- Univ Med Berlin, Klin Allgemein Visceral & Transplantat Chirurg, Charite Campus Virchow Klinikum, Berlin, Germany.
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- Pageaux, George-Philippe (författare)
- CHRU Montpellier, APEMAD, Hop St Eloi, Serv Hepatogastroenterol & Transplantat Hepat, Montpellier 5, France.
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- Pinna, Antonio D. (författare)
- Univ Bologna, Policlin S Orsola Malpighi, Chirurg Gen & Trapianti, Bologna, Italy.
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- Pirenne, Jaques (författare)
- UZ Leuven, Abdominale Transplantatiechirurg, Campus Gasthuisberg, Leuven, Belgium.
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- Pratschke, Johann (författare)
- Charite Univ Med Berlin, Augustenburger Pl 1, D-13353 Berlin, Germany.
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- Powel, James (författare)
- Royal Infirm Edinburgh NHS Trust, NHS Lothian, Hepat Pancreat Biliary Surg Serv, 51 Little France Crescent, Edinburgh, Midlothian, Scotland.;Royal Infirm Edinburgh NHS Trust, NHS Lothian, Edinburgh Transplant Unit, 51 Little France Crescent, Edinburgh, Midlothian, Scotland.
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- Rentsch, Markus (författare)
- Klinikum Ludwig Maximillians Univ Munchen Grossha, Klinikum Ingolstadt, Klin Allgemein Viszeral & Thoraxchirurg, Ingolstadt, Germany.
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- Rizell, Magnus (författare)
- Sahlgrens Univ Hosp, Dept Surg & Transplantat, Gothenburg, Sweden.
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- Rossi, Giorgio (författare)
- Fdn IRCCS Ca Granda, Osped Maggiore Policlin IRCCS Milano, Ctr Trapianti Fegato, Milan, Italy.
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- Rostaing, Lionel (författare)
- Grenoble Alpes Univ Hosp Ctr, Dept Nephrol Hemodialysis Apheresis & Transplanta, Ave Maquis Gresivaudan, La Tronche, France.
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- Roy, Andre (författare)
- Ctr Hosp Univ Montreal CHUM, Hop St Luc, Hepatobiliary & Pancreat Surg Unit, Principal Pavill,1058 Rue St Denis Montreal, Montreal, PQ, Canada.
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- Scholz, Tim (författare)
- Uppsala universitet,Transplantationskirurgi,Uppsala Univ Hosp, Dept Transplant Surg, Uppsala, Sweden.
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- Settmacher, Utz (författare)
- Univ Klinikum Jena, Klin Allgemein Viszeral & Gefasschirurg, Jena, Germany.
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- Soliman, Thomas (författare)
- Med Univ Wien, AKH Wien, Univ Klin Chirurg, Abt Transplantat, Vienna, Austria.
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- Strasser, Simone (författare)
- Royal Prince Alfred Hosp, AW Morrow Gastroenterol & Liver Ctr, Sydney, NSW, Australia.;Royal Prince Alfred Hosp, Liver Transplant Unit, Sydney, NSW, Australia.
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- Soderdahl, Gunnar (författare)
- Karolinska Institutet
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- Troisi, Roberto I. (författare)
- Ghent Univ Hosp, Ghent, Belgium.;Sch Med, Hepato Biliary & Pancreat Surg, Ghent, Belgium.
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- Sanchez Turrion, Victor (författare)
- Hosp Univ Puerta Hierromajadahonda, Dept Cirugia, Unidad Trasplante Hepat, Calle Manuel de Falla 1, Madrid, Spain.
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- Schlitt, Hans J. (författare)
- Univ Hosp Regensburg, Dept Surg, Franz Josef Strauss Allee 11, Regensburg, Germany.
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- Geissler, Edward K. (författare)
- Univ Hosp Regensburg, Dept Surg & Sect Expt Surg, Franz Josef Strauss Allee 11, Regensburg, Germany.;Fraunhofer Inst Expt Med & Toxicol, Div Tumor Therapy, Regensburg, Germany.
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Univ Klinikum Frankfurt, Klin Allgemein Viszeral & Transplantat Chirurg, Frankfurt, Germany Univ Klinikum Frankfurt, Inst Biostat & Math Modellierung, Frankfurt, Germany. (creator_code:org_t)
- LIPPINCOTT WILLIAMS & WILKINS, 2020
- 2020
- Engelska.
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Ingår i: Annals of Surgery. - : LIPPINCOTT WILLIAMS & WILKINS. - 0003-4932 .- 1528-1140. ; 272:5, s. 855-862
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: The aim of this study was to evaluate the survival benefit of sirolimus in patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC) (exploratory analysis of the SiLVER-trial). Summary and Background Data: Patients receiving LT) for HCC are at a high risk for tumor recurrence. Calcineurin inhibitors have shown evidence to promote cancer growth, whereas mammalian target of rapamycin (mTOR) inhibitors like sirolimus have anticancer effects. In the SiLVER-trial (Clinicaltrials.gov:NCT00355862), the effect of sirolimus on the recurrence of HCC after LTwas investigated in a prospective randomized trial. Although the primary endpoint of improved disease-free survival (DFS) with sirolimus was not met, outcomes were improved for patients in the sirolimus-treatment arm in the first 3 to 5 years. To learn more about the key variables, a multivariate analysis was performed on the SiLVER-trial data. Patients and Methods: Data from 508 patients of the intention-to-treat analysis were included in exploratory univariate and multivariate models for overall survival (OS), DFS and a competing risk analysis for HCC recurrence. Results: Sirolimus use for >= 3 months after LT for HCC independently reduced the hazard for death in the multivariate analysis [hazard ratio (HR): 0.7 (95% confidence interval, CI: 0.52-0.96, P = 0.02). Most strikingly, patients with an alpha-fetoprotein (AFP) >= 10 ng/mL and having used sirolimus for >= 3 months, benefited most with regard to OS, DFS, and HCC-recurrence (HR: 0.49- 0.59, P = 0.0079- 0.0245). Conclusions: mTOR-inhibitor treatment with sirolimus for >= 3 months improves outcomes in LT for HCC, especially in patients with AFP-evidence of higher tumor activity, advocating particularly for mTOR inhibitor use in this subgroup of patients. Clinical Trial Registration: EudraCT: 2005-005362-36 Clinicaltrials.gov: NCT00355862.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- AFP
- Milan criteria
- mTOR-inhibition
- multivariate COX regression
- Sirolimus
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Schnitzbauer, An ...
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Filmann, Natalie
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Adam, Rene
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Bachellier, Phil ...
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Bechstein, Wolf ...
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Becker, Thomas
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visa fler...
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Bhoori, Sherrie
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Bilbao, Itxarone
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Brockmann, Jens
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Burra, Patrizia
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Chazoullieres, O ...
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Cillo, Umberto
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Colledan, Michel ...
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Duvoux, Christop ...
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Ganten, Tom M.
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Gugenheim, Jean
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Heise, Michael
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van Hoek, Bart
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Jamieson, Nevill ...
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de Jong, Koert P ...
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Klein, Christian ...
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Klempnauer, Jurg ...
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Kneteman, Norman
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Lerut, Jan
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Makisalo, Heikki
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Mazzaferro, Vinc ...
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Mirza, Darius F.
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Nadalin, Silvio
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Neuhaus, Peter
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Pageaux, George- ...
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Pinna, Antonio D ...
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Pirenne, Jaques
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Pratschke, Johan ...
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Powel, James
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Rentsch, Markus
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Rizell, Magnus
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Rossi, Giorgio
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Rostaing, Lionel
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Roy, Andre
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Scholz, Tim
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Settmacher, Utz
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Soliman, Thomas
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Strasser, Simone
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Soderdahl, Gunna ...
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Troisi, Roberto ...
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Sanchez Turrion, ...
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Schlitt, Hans J.
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Geissler, Edward ...
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MEDICIN OCH HÄLS ...
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Uppsala universitet
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Karolinska Institutet