Objective To observe efficacy of rapamycin combined with sorafenib in hepatocellular carcinoma (HCC) patients with tumor recurrence after liver transplantation beyond Milan criteria. Methods Forty-one beyond Milan criteria HCC patients who underwent the classic orthotopic liver transplantation without bypass and the tumor postoperatively recurred in the Tianjin First Center Hospital from February 1, 2012 to August 31, 2015 were collected retrospectively, then were divided into a local treatment group (n=21) and a comprehensive treatment group (n=20). The local treatment included the surgical resection, radiofrequency ablation, transcatheter arterial chemoembolization, radioactive seed implantation, etc.. The comprehensive treatment was on the basis of the local treatment plus rapamycin in combination with sorafenib. Results There were 12 patients with stable disease and 9 patients with progressive disease in the local treatment group. There were 12 patients with partial response, 10 patients with stable disease and 8 patients with progressive disease in the comprehensive group. In the local treatment group and the comprehensive treatment group, the median survival time were 9 months and 12 months, and the 1-year and 2-year survival rates after the recurrence were 14% versus 55%, 0 versus 15%, respectively. The survival of the comprehensive treatment group was significantly better than that of the local treatment group (P<0.01). Conclusion Combination of rapamycin and sorafenib in HCC patients with tumor recurrence after liver transplantation beyond Milan criteria can significantly improve survival time of patient with recurrence.
ObjectiveTo investigate the role of non-coding RNA (ncRNA) in the proliferation, migration and metastasis of hepatocellular carcinoma (HCC) and the mechanism of HCC resistance to sorafenib.MethodThe literatures of ncRNA studies related to the incidence of HCC in recent years were reviewed, and the relationship between different ncRNAs and the proliferation, migration and metastasis of HCC was summarized, and the mechanism of sorafenib resistance in the HCC was analyzed from the perspective of ncRNA.ResultsThere were many kinds of ncRNAs, which were classified into the long ncRNA and short ncRNA according to their length. Currently, microRNA, which was widely studied, belonged to the short ncRNA. The regulation of the expressions of different microRNAs and long ncRNA could enhance or inhibit the signaling pathway of the producing HCC and played an important guiding role in the diagnosis and treatment of HCC. Meanwhile, the targeted regulation of this ncRNA could reverse the sorafenib resistance in the HCC.ConclusionsncRNA plays an important role in the pathogenesis of HCC and has become a potential target for the treatment of HCC. Targeted regulation of specific ncRNA expression could reverse sorafenib resistance in HCC.
Objective To summarize the papers about the research status and prospects of ferroptosis in hepatocellular carcinoma (HCC) and its drug resistance in recent years in order to provide directions and ideas for the treatment of HCC. Method The relevant literatures at home and abroad in recent years about ferroptosis in HCC and its drug resistance were reviewed. Results The mechanism of ferroptosis in the development and drug resistance of HCC was complicated, involving multiple protein and molecular pathways. Ferroptosis played an important role in improving chemotherapy and sorafenib resistance, and it had a broad application prospect in HCC. Conclusions The molecular mechanism of ferroptosis in HCC and its drug resistance has not been fully elucidated. Further research on the mechanism of ferroptosis in HCC may provide new molecular therapeutic targets for HCC. Ferroptosis has a broad application prospect in the treatment of HCC.