Gertjan Rasschaert, Medical Doctor and Consultant specializing in Gastrointestinal Oncology and Gastroenterology at UZ Leuven, shared a post on LinkedIn:
“Today was a good day! Thank you American Society of Clinical Oncology (ASCO) for the opportunity to present our research with an oral communication at ASCO GI26 in San Francisco.
Liver transplantation (LTx) for unresectable colorectal liver metastases (uCLM).
Pooled real-world data from all Belgian liver transplant centers:
- 29 patients
- median duration of chemotherapy before LTx 13 months
- median follow up 20.5 months
- 11 recurrences, mainly pulmonary
- median time to recurrence 6.3 months
- 2-year-OS 90.1% (95 CI 74,4-100)
- 2-year-RFS 54.8% (95 CI 37.3-80.1)
- Median OS after recurrence 26.5 months.
- 2 pMMR, BRAF V600E mt patients with 4+ years of follow up without recurrence
We need harmonized and strict selection protocols in order to improve these outcomes!
ur newly established Belgian protocol is the first LTx indication where there is national consensus on selection criteria across all 6 accredited LTx centers.
We created a national independent validation committee as per TransMet.
Two main criteria:
- Unresectabel CLM as per expert surgeon agreement.
- No (history) of metastatic disease beyond the liver.
Two strict requirements:
- Minimum 6 months of partial response and/or stable disease on same treatment line.
- Mandatory 8 weeks therapeutic pause with no progression beyond the liver. This period may be used to resect the primary tumor.
With a stricter ‘test of time’, we believe the nasty biologies will be filtered out naturally. Thus, no need for discrimination based only on point mutations or histology. Time will tell..
Belgium, a country of only 11 million people, has more than 300 LTx patients per year (and increasing). We anticipate to transplant 15 uCLM cases per year across Belgium with these criteria. Both through patient offer and center offer, DBD and DCD. When listed 28 MELD points are granted. We anticipate to transplant within 1-2 months after listing.
With a mortality of around 12% on the Belgian waiting list for LTx, we do take these cases serious and respect other (mostly benign) treatment indications.”
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