Pre-TACE Immune Status Correlates with Treatment Response and Tumor Biology in HCC as a Bridge to Transplant.

T. Sandow,¹ H. Bohorquez,² D. Kirsch,¹ A. Albar,¹ P. Thevenot,³ K. Nunez,³ D. DeVun,¹ J. Gimenez,¹ G. Galliano,⁴ A. Cohen,² G. Loss,² D. Kay,¹ P. Gulotta.¹

¹Radiology, Ochsner Clinic Foundation, New Orleans, LA
²Transplant Surgery, Ochsner Clinic Foundation, New Orleans, LA
³Institute of Translational Research, Ochsner Clinic Foundation, New Orleans, LA
⁴Pathology, Ochsner Clinic Foundation, New Orleans, LA

Meeting: 2017 American Transplant Congress

Abstract number: A76

Keywords: Hepatocellular carcinoma, Liver transplantation, Lymphocytes, Tumor recurrence

Session Information

Session Name: Poster Session A: Clinical Science: Liver - Hepatocellular Carcinoma and Cholangiocarcinoma Malignancies

Session Type: Poster Session

Date: Saturday, April 29, 2017

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall D1

Purpose:

Immune factors are pivotal against disease progression after transplant in hepatocellular carcinoma (HCC). With chemoembolization (TACE) as a bridge to liver transplant, this study compares imaging response characteristics to TACE based on pre-treatment immune markers, using explant pathology for confirmation of tumor biology.

Materials:

Retrospective analysis was performed on all patients who were treated for HCC with TACE (100-300[micro] LC Beads™ mixed with doxorubicin) from 7/2011 to 5/2016 and subsequently transplanted (n=93). Serum analysis was performed on the morning of TACE. Primary treatment response was based on modified RECIST criteria at one-month follow-up imaging. Patients with history of prior locoregional therapy were excluded from analysis. Post-treatment imaging response was compared with pre-treatment laboratory markers and tumor biology. 82 patients were followed after transplant (mean time of follow-up, 659 days).

Results:

Pre-treatment absolute lymphocyte counts (ALC) were lower in patients with stable disease (SD) at follow-up compared to patients with complete response (CR) or partial response (PR), 1.09 in SD vs 1.43 in CR/PR, p=0.02. ALC correlated with serum albumin at the time of TACE (r=0.22, p=0.04). ALC values did not correlate with tumor grade (1.37 in G1/G2 vs 1.11 in G3/G4, p=0.41). However, lower pre-treatment ALC values were associated with the presence lymphovascular invasion (LVI) and/or satellite nodules (SN) at liver explant (1.05 vs 1.43, p=0.01). Post-transplant recurrence was identified in 7 patients. LVI and/or SN occurred in 71.4% with recurrence vs 25.3% without recurrence, p=0.02.

Conclusions:

Unfavorable TACE treatment response was associated with low lymphocyte counts, a marker for immunosurveillance. Low ALC values were also associated with low serum albumin values. This suggests that an unfavorable treatment response and poor tumor biology may be associated with diminished immune and nutritional status, regardless of tumor grade, which could play a role in transplant bridging and post-transplant success.

CITATION INFORMATION: Sandow T, Bohorquez H, Kirsch D, Albar A, Thevenot P, Nunez K, DeVun D, Gimenez J, Galliano G, Cohen A, Loss G, Kay D, Gulotta P. Pre-TACE Immune Status Correlates with Treatment Response and Tumor Biology in HCC as a Bridge to Transplant. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Sandow T, Bohorquez H, Kirsch D, Albar A, Thevenot P, Nunez K, DeVun D, Gimenez J, Galliano G, Cohen A, Loss G, Kay D, Gulotta P. Pre-TACE Immune Status Correlates with Treatment Response and Tumor Biology in HCC as a Bridge to Transplant. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-tace-immune-status-correlates-with-treatment-response-and-tumor-biology-in-hcc-as-a-bridge-to-transplant/. Accessed May 17, 2025.

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