Complete response of advanced hepatocellular carcinoma to sorafenib : another case and a comprehensive review

Abstract

Since sorafenib was introduced in 2007 for treating advanced hepatocellular carcinoma (HCC), 15 patients have achieved a complete response (CR) in advanced HCC. However, only four of these reports can be regarded as real CRs involving adequate assessments including imaging, serum tumor markers, and histologic examinations of completely resected specimens. A 54-year-old man with hepatitis C virus (HCV)-related liver cirrhosis (LC) presented to our unit. A CT scan demonstrated a 3.8-cm arterial hypervascular/portal-washout mass in the right lobe and invasion in the right portal vein. Twelve weeks after beginning sorafenib therapy, the AFP level was normalized and a CT scan showed a prominent decrease in the hepatic mass and a significant decrease in the volume of portal vein thrombosis (PVT). The patient received a right liver hemihepatectomy after 12 months. No viable tumor cells were found in the resected specimen, and there was no thrombotic obstruction of the portal vein. Twelve months later the patient showed no clinical evidence of HCC recurrence. This is the first case of CR in HCC treatment following sorafenib with histologically confirmed HCV-related HCC without LC evidence, HCC with PVT, and a follow-up of longer than 12 months. This case seems to be an extremely unusual clinical outcome in advanced HCC.

Reversion of tumor hepatocytes to normal hepatocytes during liver tumor regression in an oncogene transgenic zebrafish model

“…The samples were sequenced using the Hi-Seq platform to a depth of 30- to 50-million reads, and 62-76% of the reads could be uniquely mapped to the zebrafish reference sequence database. A total of 12,768 transcripts with a fragment per kilobase million (FPKM) >1 in at least one of the ten samples were considered as meaningfully expressed transcripts (Kim et al, 2017). The Euclidean distance between samples was calculated based on the log-transformed FPKM values of the 12,768 expressed transcripts and presented in a heatmap with clustering (Fig.…”

“…Currently, only two drugs, sorafenib and regorafenib, which target tumor angiogenesis and cell proliferation, have been approved by the US Food and Drug Administration (FDA) for treatment of HCC patients. In addition to its therapeutic benefits to some HCC patients, sorafenib could even cause complete regression of HCC, which has been reported in a few cases (Kim et al, 2017). However, the cytological mechanism by which a complete response was achieved is still unclear, although tumor apoptosis and hypoxia due to vascularization inhibition are known to be involved (Kourtidis et al, 2015).…”

“…Differentially expressed genes were determined with Cuffdiff (Trapnell et al, 2012). An FPKM cutoff of 1 in at least one of the ten samples was applied to capture meaningfully expressed transcripts (Kim et al, 2017). Differentially expressed genes were determined by a fold change >2 and FDR-adjusted P -value <0.05.…”

Lenvatinib is independently associated with the reduced risk of progressive disease when compared with sorafenib in patients with advanced hepatocellular carcinoma

“…Systemic targeted therapy for advanced HCC changed drastically following the introduction of sorafenib in 2007 14–16 . Over the last decade, sorafenib has been the only first‐line treatment proven to extend overall survival (OS) of patients with advanced HCC.…”

Sustained complete response of advanced hepatocellular carcinoma with metronomic capecitabine: a report of three cases

“…Sorafenib is considered moderately effective in HCC treatment, with a less than 3-month increase in overall survival (OS) in comparison with placebo [ 3 ]. Cases of complete response (CR) to sorafenib have been reported in the literature [ 5 ], but no data on the duration of the CR are available.…”