Adding dendritic cell-immunotherapy for post-transplant hepatocellular carcinoma recurrence

Background Hepatocellular carcinoma (HCC) recurrence after liver transplantation is frequently multiple and extrahepatic, and with a poor prognosis. The therapeutic effects of current medications for post-transplant HCC recurrence are limited. This study assessed whether outcomes could be improved by adding dendritic cell (DC)immunotherapy to the treatment regimen. Methods Eleven patients treated with tyrosine kinase inhibitors and DC-immunotherapy for post-transplant HCC recurrence between 2020 and 2024 were included. DC were propagated from peripheral blood monocytes and pulsed with tumor lysate. Historical data of patients (n =23) with tyrosine kinase inhibitors for post-transplant HCC recurrence between 2009 and 2020 were collected as a reference. Results Seven male and four female patients were included in this study. The median (interquartile) tumor recurrence time after transplantation was 35.0 (7.4-55.3) months. The median number of DC-immunotherapy were 5 ranged from 3 to 10, and the median number of cells admitted was 29.5x10 6 cells ranged from 16.0 to 137.2 x10 6 cells. Responses to DC-immunotherapy included nine stable diseases and two progressive diseases. No adverse effects related to DC treatment were observed. The 1-, 2- and 3- year survival rates were 70.7%, 40.4%, and 40.4%, respectively, compared to 52.5%, 17.4%, and 8.7%, respectively, for patients treated with tyrosine kinase inhibitors only ( p = 0.050). Conclusion DC immunotherapy is a safe treatment for transplant recipients with HCC recurrence. Adding DC-immunotherapy to the treatment regimen could prolong the survival of some patients.