24 March 2026 : Original article
Immune Checkpoint Inhibitors for Recurrent Hepatocellular Carcinoma After Liver Transplantation: Safety Under an Immunosuppression-Preserving Strategy
Shih-Chao Hsu ABCDEF 1,2*, Sheng-Hsien Chen AE 1,2, Te-Hong Chen AE 1,2, Wei-Fan Hsu AE 3, Hung-Wei Wang AE 3,4, Chun-Chieh Yeh AE 1,2,3,5, Horng-Ren Yang AE 1,2, Hsueh-Chou Lai AE 3, Long-Bin Jeng AE 1,2DOI: 10.12659/AOT.952135
Ann Transplant 2026; 31:e952135
Table 3 Clinical characteristics, treatment regimens, and outcomes of patients receiving immune checkpoint inhibitors as first- and second-line therapy after post–liver transplant hepatocellular carcinoma recurrence.
| Patient | LT to recurrence (month) | Treatment start date (M/D/Y) | ICI classification | PFS (month) | Outcome | ≥Grade 2 irAEs |
|---|---|---|---|---|---|---|
| 1 | 10.5 | 8/8/2018 | Pembrolizumab | 5.6 | Progression | – |
| 2 | 1.2 | 9/25/2019 | Nivolumab | 2.9 | Progression | Elevated liver enzymes |
| 3 | 34.3 | 10/24/2018 | Nivolumab | 8.4 | Progression | – |
| 4 | 45.1 | 11/23/2022 | Atezolizumab + Bevacizumab | 31.7 | Complete response | – |
| 5 | 4.6 | 5/10/2020 | Pembrolizumab + Lenvatinib | 6.4 | Progression | – |
| 6 | 2.3 | 2/13/2021 | Pembrolizumab + Lenvatinib | 10.4 | Progression | – |
| 7 | 5.0 | 9/5/2018 | Nivolumab | 3.0 | Progression | – |
| 8 | 35.8 | 9/21/2022 | Pembrolizumab + Lenvatinib | 2.3 | Progression | – |
| 9 | 4.0 | 10/25/2022 | Atezolizumab + Bevacizumab | 4.9 | Progression | – |
| 10 | 2.7 | 3/24/2021 | Pembrolizumab + Lenvatinib | 4.9 | Progression | – |
| 11 | 9.6 | 6/05/2024 | Atezolizumab + Bevacizumab | 3. | Progression | – |
| 12 | 6.1 | 12/22/2017 | Pembrolizumab | 3.8 | Progression | – |
| 1 | 9.5 | 8/10/2017 | Pembrolizumab | 3.8 | Progression | GI bleeding |
| 2 | 0.4 | 9/30/2017 | Nivolumab | 4.7 | Progression | – |
| 3 | 56.3 | 12/14/2017 | Pembrolizumab + Lenvatinib | 26.9 | Progression | – |
| 4 | 1.7 | 5/27/2020 | Pembrolizumab + Lenvatinib | 13.7 | Progression | GI bleeding |
| 5 | 10.4 | 2020/12/23 | Pembrolizumab + Lenvatinib | 32.5 | Progression | – |
| 6 | 34.5 | 7/13/2021 | Nivolumab | 48.3 | Complete response | – |
| 7 | 3.7 | 7/13/2021 | Atezolizumab + Bevacizumab | 4.8 | Progression | – |
| 8 | 7.9 | 8/9/2023 | Pembrolizumab + Lenvatinib | 7.2 | Progression | – |
| 9 | 52.9 | 3/31/2023 | Atezolizumab + Bevacizumab | 27.4 | Stable disease | – |
| 10 | 12.2 | 6/26/2019 | Nivolumab | 9.4 | Progression | – |
| 11 | 2.3 | 1/11/2022 | Pembrolizumab + Lenvatinib | 3.8 | Progression | – |
| 12 | 3.0 | 1/14/2025 | Atezolizumab + Bevacizumab | 1.1 | Progression | – |
| 13 | 9.6 | 9/05/2024 | Pembrolizumab + Lenvatinib | 3.7 | Progression | – |
| LT – liver transplantation; ICIs – immune checkpoint inhibitors; irAEs – immune-related advent events; GI – gastrointestinal. | ||||||