Patients with advanced liver cancer who undergo surgery or receive a liver transplant after immunotherapy have significantly improved survival rates, according to a recent study by Cedars-Sinai Cancer. The findings, published in the journal Liver Cancer, indicate that these patients experienced overall survival rates 85% higher than those treated with immunotherapy alone.
“The data we reviewed showed that patients who received follow-up transplants or tumor removal after immunotherapy reduced the size of their tumors lived much longer than patients who just remained on immunotherapy,” said Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai and senior author of the study.
Liver cancer is often diagnosed at an advanced stage, making curative surgery or transplantation less feasible. Immunotherapy can help shrink tumors but does not typically cure the disease in these cases. Prior research led by Cedars-Sinai suggested that tumor reduction through immunotherapy could make surgical interventions possible for some patients. This new analysis assessed how these subsequent procedures affected patient outcomes.
Researchers examined data from more than 4,300 individuals with advanced liver cancer in the National Cancer Database, which covers over 70% of new cancer diagnoses in the United States. Despite evidence supporting improved survival after surgery or transplantation following immunotherapy, only about 3% of eligible patients underwent these procedures. Most were treated at academic medical centers such as Cedars-Sinai.
“Performing liver transplant following immunotherapy isn’t yet common practice,” Yang said. “This is unfortunate, as patients with advanced liver cancer often die without such treatment—even if their cancer is under control—because they also have other liver ailments. A transplant leaves the patient with a healthy liver.”
Yang intends to further advocate for broader use of surgical options post-immunotherapy through a forthcoming study enrolling patients who receive both treatments and tracking their results.
“When our physician-scientists create studies based on patient needs and then apply their findings to patient care, it improves outcomes for everyone we serve and for patients around the world,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer. “As an academic medical center, that is our mission.”
Cedars-Sinai Medical Center is located in Los Angeles and was established in 1902. The hospital’s president is Thomas M. Priselac. As a teaching institution with pediatric services, it admitted more than 50,000 patients in 2022 (https://www.cedars-sinai.org/about-us/annual-report.html).
Additional authors from Cedars-Sinai include Gwang Hyeon Choi, Hyun-Seok Kim, Michael Luu, Alexander Kuo, Walid S. Ayoub, Hirsh Trivedi, Yun Wang, Aarshi Vipani, Pin-Jung Chen, Steven A. Miles, Emily A. Kaymen, Andrew Hendifar, Tsuyoshi Todo, Todd V. Brennan, Georgios Voidonikolas, Steven A. Wisel, Justin Steggerda, Cristina Ferrone, Kambiz Kosari and Nicholas Nissen; other contributors include Neehar D. Parikh and Amit G. Singal.
The research was supported by grants from the National Cancer Institute: Dr. Singal received funding under R01 MD012565 and R01 CA256977; Dr. Yang’s work was funded by NCI K08CA259534.
Ju Dong Yang disclosed consulting roles for AstraZeneca, Eisai, Exact Sciences, Exelixis and Fujifilm Medical Sciences.
Cedars-Sinai Health Sciences University continues its commitment to advancing research and training future healthcare leaders.
