Hepatocellular Carcinoma: The Evolving Role of Systemic Therapies as a Bridging Treatment to Liver Transplantation.

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths. Classically, liver transplantation (LT) can be curative for HCC tumors within the Milan criteria. Bridging strategies to reduce the dropouts from LT waiting lists and/or to downstage patients who are beyond the Milan criteria are widely utilized. We conducted a literature-based review to evaluate the role of systemic therapies as a bridging treatment to liver transplantation (LT) in HCC patients. Tyrosine kinase inhibitors (TKIs) can be used as a systemic bridging therapy to LT in patients with contraindications for locoregional liver-directed therapies. Immune checkpoint inhibitor (ICI) treatment can be utilized either as a monotherapy or as a combination therapy with bevacizumab or TKIs prior to LT. Acute rejection after liver transplantation is a concern in the context of ICI treatment. Thus, a safe ICI washout period before LT and cautious post-LT immunosuppression strategies are required to reduce post-LT rejections and to optimize clinical outcomes. Nevertheless, prospective clinical trials are needed to establish definitive conclusions about the utility of systemic therapy as a bridging modality prior to LT in HCC patients.

Novel self-dyed wholly aromatic polyamide-hydrazides covalently bonded with azo groups in their main chains: 1. Structure-property relationships.

Twelve novel intrinsically colored wholly aromatic azopolyamide-hydrazides containing various proportions of para- and meta-phenylene units were successfully synthesized by a low temperature (-10 °C) solution polycondensation reaction of either 4-amino-3-hydroxybenzhydrazide (4A3HBH) or 3-amino-4-hydroxybenzhydrazide (3A4HBH) with an equimolar amount of either 4,4'-azodibenzoyl chloride (4,4'ADBC), 3,3'-azodibenzoyl chloride (3,3'ADBC), or mixtures of various molar ratios of 4,4'ADBC and 3,3'ADBC in anhydrous N,N-dimethyl acetamide (DMAc) containing 3% (wt/v) LiCl as a solvent. The structures of the polymers were proven by elemental analysis, FTIR, ¹H- and ¹³C-NMR spectroscopy. The polymers' properties were strongly affected by their various structures. The intrinsic viscosities of the polymers were ranged from 0.7 to 4.75 dL g⁻¹ and increased with the para-phenylene units content. The polymers are partially soluble in DMAc, dimethyl formamide (DMF) and N-methyl-2-pyrrolidone (NMP). Their solubility increases with the introduction of meta-phenylene moieties into the polymer chains. The polymers exhibit a great affinity for water sorption. Their hydrophilicity increases as a function of the content of meta-phenylene rings incorporated into the polymer. Mechanical properties of the polymer films are improved markedly by substitution of para-phenylene units for meta-phenylene units. The completely para-oriented type polymer has the best thermal and thermo-oxidative stability relative to those of the other polymers.