Open Access

Novel strategy of sirolimus plus thymalfasin and huaier granule on tumor recurrence of hepatocellular carcinoma beyond the UCSF criteria following liver transplantation: A single center experience

  • Authors:
    • Lin Zhou
    • Li‑Chao Pan
    • Yong‑Gen Zheng
    • Guo‑Sheng Du
    • Xiao‑Qian Fu
    • Zhi‑Dong Zhu
    • Ji‑Yong Song
    • Zhi‑Jia Liu
    • Xiang‑Zheng Su
    • Wen Chen
    • De‑Hua Zheng
    • Long‑Long Suo
    • Shao‑Zhen Yang
  • View Affiliations

  • Published online on: July 27, 2018     https://doi.org/10.3892/ol.2018.9226
  • Pages: 4407-4417
  • Copyright: © Zhou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Although liver transplantation (LT) lengthens the survival time of patients with hepatocellular carcinoma (HCC), LT patients exhibit a high recurrence rate; particularly those that had advanced HCC associated with the tumor biological characteristics and long‑term application of immunosuppressants. A consensus on optimal prophylaxis and treatment for recurrent HCC following LT does not currently exist. The present study retrospectively analyzed data from 36 non‑University of California at San Francisco criteria‑eligible patients with advanced HCC who underwent LT, and then treated them with sirolimus (SRL)‑based therapy with thymalfasin and huaier granules (SRL+, n=18), or with tacrolimus‑based therapy (controls; n=18). The SRL+ group had significantly longer recurrence times (P=0.008) and survival times (P<0.0001) (OS, 1‑year: 100%, 3‑year: 94.4%, 5‑year: 77.8%; DFS, 1‑year: 88.9%, 3‑year: 55.6%, 5‑year: 50.0%). Furthermore, compared with pre‑LT values and the control group, the SRL+ group had significantly lower serum α‑fetoprotein (AFP) levels (both P<0.0001) and percentage of Forkhead box P3 (FoxP3)+ Treg lymphocytes (P<0.001) during the first year. In the SRL+ group, FoxP3+/cluster of differentiation (CD)8+ Treg lymphocyte percentages decreased significantly following LT (P<0.001); however, CD8+/CD3+ T‑cells significantly increased (P<0.001). Levels of serum AFP and FoxP3+ Treg cells increased when tumors relapsed, and decreased to near‑normal when relapse foci were cured or stabilized. SRL+ therapy may decrease AFP and Treg levels, while increasing CD8+ T cells, indicating an associated mechanism among them. In conclusion, SRL+ therapy appears to be safe and effective in preventing HCC recurrence following LT with no significant adverse events, and warrants further investigation.
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October-2018
Volume 16 Issue 4

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Copy and paste a formatted citation
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Spandidos Publications style
Zhou L, Pan LC, Zheng YG, Du GS, Fu XQ, Zhu ZD, Song JY, Liu ZJ, Su XZ, Chen W, Chen W, et al: Novel strategy of sirolimus plus thymalfasin and huaier granule on tumor recurrence of hepatocellular carcinoma beyond the UCSF criteria following liver transplantation: A single center experience. Oncol Lett 16: 4407-4417, 2018
APA
Zhou, L., Pan, L., Zheng, Y., Du, G., Fu, X., Zhu, Z. ... Yang, S. (2018). Novel strategy of sirolimus plus thymalfasin and huaier granule on tumor recurrence of hepatocellular carcinoma beyond the UCSF criteria following liver transplantation: A single center experience. Oncology Letters, 16, 4407-4417. https://doi.org/10.3892/ol.2018.9226
MLA
Zhou, L., Pan, L., Zheng, Y., Du, G., Fu, X., Zhu, Z., Song, J., Liu, Z., Su, X., Chen, W., Zheng, D., Suo, L., Yang, S."Novel strategy of sirolimus plus thymalfasin and huaier granule on tumor recurrence of hepatocellular carcinoma beyond the UCSF criteria following liver transplantation: A single center experience". Oncology Letters 16.4 (2018): 4407-4417.
Chicago
Zhou, L., Pan, L., Zheng, Y., Du, G., Fu, X., Zhu, Z., Song, J., Liu, Z., Su, X., Chen, W., Zheng, D., Suo, L., Yang, S."Novel strategy of sirolimus plus thymalfasin and huaier granule on tumor recurrence of hepatocellular carcinoma beyond the UCSF criteria following liver transplantation: A single center experience". Oncology Letters 16, no. 4 (2018): 4407-4417. https://doi.org/10.3892/ol.2018.9226