Immunotherapy Use Prior to Liver Transplant in Patients with Hepatocellular Carcinoma
, Alexandra V. Kimchy 2, Lynette M. Sequeira 3, Charles S. Dorris 4, Aiwu R. He 5 and Amol S. Rangnekar 6
Round 1
Reviewer 1 Report
Some aspects of this review have been beyond the content of the title, Immunotherapy use prior to liver transplant in patients with hepatocellular carcinoma, such as, Epidemiology, Risk Factors, HCC Surveillance and Diagnosis. I suggest deleting these contents
Author Response
Thank you for your constructive feedback. The sections noted to be outside of the scope of the paper by the reviewer have been removed from the manuscript. The manuscript has been revised by a native English speaker.
Reviewer 2 Report
The review is devoted to the important issues in terms of cancer therapy and analyse a number of recent studies describing benefits for usage of immunotherapy prior to liver transplantation. In general it is a well-structured review, however some major changes are needed:
1. First of all the author should thoroughly think and select whether this is meta-analysis paper or the review. To date the manuscript is a mixture of this two and in the middle even may confuse readers by some phases from typical research article like «we identified 45 patients» etc
2. Anyway it is quite confusing to read in the abstract useless numbers of analysed manuscripts and keywords by which the authors searched for papers in the databases and etc. Evidently, abstract should highlight main findings of the work (even if it is a review) because everyone can type those keywords in google and make his/her own review. Please totally re-write the abstract in order to deal with scientific details.
3. It is very strange to meet Materials and methods section in the review
4. Figure 1 is has some mistakes in numbers
5. 21 keywords is evidently too much for overlapping search so evidently the authors used this keywords independently and then pull together all the papers?
6. There is absolutely no explanation how the authors selected last 24 publication from the list of 3462, what was the selection criteria. If there were only 24 with pre-transplantant immunotherapy - it has no sense to show all the filtering flowchart. In this case you should better just start with exact keyword or overlapping keyword search.
7. The authors should be more careful with references. In the present state of the manuscript there are many long paragraphs with many details but with the only one reference in the end. It looks a bit confusing.
Author Response
Thank you for the constructive feedback. Our team's response to each comment can be found below in bold:
- First of all the author should thoroughly think and select whether this is meta-analysis paper or the review. To date the manuscript is a mixture of this two and in the middle even may confuse readers by some phases from typical research article like «we identified 45 patients» etc
This is a review paper. The methods section has been removed from the manuscript to minimize confusion for readers.
- Anyway it is quite confusing to read in the abstract useless numbers of analysed manuscripts and keywords by which the authors searched for papers in the databases and etc. Evidently, abstract should highlight main findings of the work (even if it is a review) because everyone can type those keywords in google and make his/her own review. Please totally re-write the abstract in order to deal with scientific details.
The abstract has been revised to focus more on the findings of the literature review rather than the numbers of analyzed manuscripts and keywords, the details of which have been removed from the abstract.
- It is very strange to meet Materials and methods section in the review
This section has been removed from the paper to minimize confusion for the reader.
- Figure 1 is has some mistakes in numbers
Figure 1 has been removed from the paper to minimize confusion for the reader.
- 21 keywords is evidently too much for overlapping search so evidently the authors used this keywords independently and then pull together all the papers?
The methods section and the keywords have been removed from the manuscript.
- There is absolutely no explanation how the authors selected last 24 publication from the list of 3462, what was the selection criteria. If there were only 24 with pre-transplantant immunotherapy - it has no sense to show all the filtering flowchart. In this case you should better just start with exact keyword or overlapping keyword search.
On page 4, line 178, we clarify that we found 24 original research publications that covered the topic of pre-liver transplant immunotherapy use in HCC patients. We have removed the flowchart.
- The authors should be more careful with references. In the present state of the manuscript there are many long paragraphs with many details but with the only one reference in the end. It looks a bit confusing.
The manuscript has been revised so that all paragraphs are sufficiently supported with citations. There are no long paragraphs with only one reference at the end.
Reviewer 3 Report
This work is very interesting in the knowledge of HCC, when it is unresectable focusing on the role of immunotherapy. It is an update that serves to try to carry out prospective and randomized studies in the understaging of HCC in liver transplantation. In summary, a very interesting and very useful literature review.
Author Response
Thank you for your feedback. We appreciate your thoughtful review of our manuscript.
Reviewer 4 Report
The authors reviewed the pre-liver transplant immunotherapy use in patients with HCC. The flow of the current review writing is convenient and easy to understand. It covers almost all the required information. I recommend this article for publication after minor revisions of the typo errors. Furthermore, the authors may add more details about the Fibrosis scoring as A or F scores, and I usually advise the authors who publish a review to innovate figures (if possible) to ease the data demonstration.
Author Response
Thank you for your thoughtful comments on our manuscript.
Our manuscript has been reviewed by multiple English language speakers.
We agree that fibrosis scoring is an important part of HCC management, though we believe that an in-depth discussion would be out of the scope of this manuscript.
We have included original tables in our manuscript, which we believe strengthen the text overall.
Round 2
Reviewer 1 Report
No further comments. I recommend accepted.
