title: Sorafenib use in the transplant setting.
abstract: Liver transplantation (LT) is an established treatment for hepatocellular carcinoma (HCC), and sorafenib (SFN) is a validated treatment for patients harboring advanced tumors. It is still not clear whether the combination of the 2 treatments, with SFN used in the neoadjuvant, adjuvant, or recurrence setting, is useful and cost-effective. This article summarizes the present evidence in favor of and against the use of SFN in the setting of LT for HCC, and it also includes the problem of toxicity, particularly when mammalian target of rapamycin inhibitors, which play a central role in regulating cellular growth and proliferation, are used as immunosuppressants. Overall, the data do not support the use of SFN in the pre- or post-LT setting as adjuvant therapy, and additional studies are needed to reach sound conclusions on the topic.
authors.affiliation: Department of Surgery, Oncology, and Gastroenterology, Padua University School of Medicine, Padua, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Castelli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.forename: Anna
authors.initials: A
authors.lastname: Giacomin
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vitale
authors.forename: Marco
authors.initials: M
authors.lastname: Senzolo
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
authors.forename: Fabio
authors.initials: F
authors.lastname: Farinati
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib