The management of hepatocellular carcinoma (HCC) recurrence after liver transplantation is an unmet need in therapeutics. This is because under immunosuppression, cancer develops early during the post-transplant period and has a higher chance of extrahepatic spreading, particularly if the pretransplant HCC status exceeds Milan or University of California San Francisco criteria.^1–3 In this scenario, locoregional therapy, which is the first-line therapeutic choice for recurrent HCC in nontransplant patients, may be ineffective; thus, effective management strategies are urgently required.⁴ In liver recipients with disseminated HCC recurrence, sorafenib confers survival benefits but is associated with considerable drug toxicity.⁵ Most immunotherapies for organ transplantation are intended to achieve sufficient immunosuppression to prevent organ rejection or limit autoreactivity without impairing the host’s ability to protect against opportunistic infections and malignancies. Thus, patients with new or recurrent malignancies after transplantation often have a relatively low chance of undergoing another surgery; however, in these patients, the effects of other treatment approaches may be nonsignificant.⁶ The development of systemic therapy with sustained effectiveness is required urgently.

中文翻译：

---

利用免疫疗法治疗肝细胞癌的肝受体：从移植肿瘤学的角度回顾

肝移植后肝细胞癌（HCC）复发的治疗是治疗中未满足的需求。这是因为在免疫抑制下，癌症会在移植后的早期阶段发展，并且有更高的肝外扩散机会，尤其是如果移植前的HCC状况超过米兰或加利福尼亚大学旧金山分校的标准。^1-3在这种情况下，局部区域治疗可能是无效的；局部区域治疗是非移植患者复发性HCC的一线治疗选择。因此，迫切需要有效的管理策略。⁴在肝癌具有弥漫性HCC复发的患者中，索拉非尼具有生存优势，但与相当大的药物毒性有关。⁵大多数用于器官移植的免疫疗法旨在实现足够的免疫抑制作用，以防止器官排斥或限制自身反应，而不会损害宿主预防机会性感染和恶性肿瘤的能力。因此，移植后患有新发或复发性恶性肿瘤的患者进行另一次手术的机会通常相对较低。但是，在这些患者中，其他治疗方法的效果可能不明显。⁶迫切需要开发持续有效的全身疗法。