Complete Response of Advanced Hepatocellular Carcinoma with Multiple Lung Metastases Treated with Sorafenib: A Case Report

Inuzuka, Tadashi; Nishikawa, Hiroki; Sekikawa, Akira; Takeda, Haruhiko; Henmi, Shinichiro; Sakamoto, Azusa; Saito, Sumio; Kita, Ryuichi; Kimura, Tōru; Osaki, Yukio; Kudo, Masatoshi

doi:10.1159/000333279

Cited by 41 publications

(41 citation statements)

References 26 publications

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“…Abbadessa et al (28) reported that HCC patients benefited from the long-lasting effects of sorafenib. In addition, we have previously treated a patient with advanced HCC with lung metastasis who achieved CR with sorafenib (29). These results suggest that a number of patients may achieve an objective response with sorafenib therapy (27)(28)(29)(30).…”

Section: Discussionmentioning

confidence: 85%

“…In addition, we have previously treated a patient with advanced HCC with lung metastasis who achieved CR with sorafenib (29). These results suggest that a number of patients may achieve an objective response with sorafenib therapy (27)(28)(29)(30). However, characteristics of the patients benefiting from, as well as features associated with sorafenib-resistance have yet to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

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Impact of pretreatment serum cholinesterase level in unresectable advanced hepatocellular carcinoma patients treated with sorafenib

Takeda

Nishikawa

Iguchi

et al. 2012

Molecular and Clinical Oncology

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Abstract. The value of serum cholinesterase (ChE) level as a predictive marker in sorafenib therapy for advanced hepatocellular carcinoma (HCC) has not yet been investigated. The present retrospective study therefore analyzed the impact of the serum ChE level in 93 patients with advanced HCC treated with sorafenib. Patients were categorized into two groups: group A with pretreatment serum ChE ≥140 IU/l (n=46) and group B with pretreatment serum ChE <140 IU/l (n=47). The correlation between clinicopathological findings, including serum ChE level, and overall survival (OS) and liver damage during sorafenib therapy was investigated. The median OS of the patients was 275 days, while OS was markedly higher in group A compared to group B (P=0.002). In 70 Child-Pugh A patients, serum ChE level was a significant prognostic predictor in multivariate analysis [P=0.019, hazard ratio (HR) =2.612; 95% confidence interval (CI), 1.174-5.810]. During sorafenib treatment, 22 patients developed liver dysfunction of grade 3 or higher. Only two group A patients (4.3%) developed liver dysfunction, compared to 20 group B patients (42.6%) (P<0.001). Multivariate analysis demonstrated that the pretreatment serum ChE level was the strongest predictor of liver damage (P= 0.002, HR= 0.061, 95% CI: 0.010-0.373), indicating serum ChE <140 IU/l to be the only independent predictor associated with severe liver function damage during sorafenib treatment in 70 patients with grade A Child-Pugh (P= 0.016; HR= 0.122; 95% CI, 0.022-0.676). In conclusion, lower serum ChE level is a significant predictor of poor prognosis and severe liver damage in HCC patients treated with sorafenib. Advanced HCC patients with lower serum ChE levels, including those with a Child-Pugh A pretreatment liver function score, should be given sorafenib therapy with caution.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Impact of pretreatment serum cholinesterase level in unresectable advanced hepatocellular carcinoma patients treated with sorafenib

Takeda

Nishikawa

Iguchi

et al. 2012

Molecular and Clinical Oncology

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“…Sorafenib therapy did not achieve a complete response in 299 patients in the Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) study or 150 patients in the Asian Pacific study; the partial response rates were 2.0% and 3.3%, respectively (6,7). Only a few studies have reported a complete response in HCC patients receiving sorafenib treatment (8)(9)(10)(11)(12)(13)(14)(15)(16). We listed these in order of the time to cessation (Table).…”

Section: Discussionmentioning

confidence: 99%

A Complete Response Induced by 21-day Sorafenib Therapy in a Patient with Advanced Hepatocellular Carcinoma

et al. 2013

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The response rate and overall survival after sorafenib administration in patients with advanced hepatocellular carcinoma are unsatisfactory. We herein present the case of a 65-year-old man with multiple lung metastases of hepatocellular carcinoma. Because the patient had liver cirrhosis of Child-Pugh B accompanied by pancytopenia, sorafenib administration was initiated at a dose of 400 mg daily. Although he received sorafenib for only 21 days, the patient exhibited complete regression of the tumors. There was no clinical evidence of recurrence without the administration of anticancer treatment. It is unique that short-term sorafenib treatment achieved a complete response.

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“…The current clinical practice guideline of the Barcelona Clinic Liver Cancer staging system4 recommends sorafenib as standard treatment for advanced HCC. The achievement of a CR after sorafenib treatment has rarely been reported,5–16 and the reduction of doses because of adverse effects is frequent 7,9,15. Our study reports that a patient with advanced HCC with right portal vein thrombosis (PVT) was treated with sorafenib.…”

Section: Introductionmentioning

confidence: 93%

Serial changes of clinical parameters in a patient with advanced hepatocellular carcinoma with portal vein thrombosis achieving complete response after treatment with sorafenib

Kee¹,

Hung²,

Wang³

et al. 2014

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The prognosis is usually poor in advanced hepatocellular carcinoma (HCC). Sorafenib is approved for Child-Pugh class A patients with unresectable and advanced HCC. We report here a rare case of a patient with advanced HCC with right portal vein thrombosis (PVT) who achieved a complete response after treatment with sorafenib. This 74-year-old man was a case of non-hepatitis B and C virus-related cirrhosis. Multiphase liver computed tomography showed an 8 cm tumor with early enhance, early wash out, and right PVT at segment 8 of the right lobe. A liver tumor biopsy confirmed the diagnosis of poorly differentiated HCC. Blood tests showed Child-Pugh class A cirrhosis and an alpha-fetoprotein level of 33,058 ng/mL. Sorafenib was initiated at 800 mg/day but was eventually reduced to 400 mg every other day because of a grade 3 hand-foot skin reaction. The alpha fetoprotein (AFP) level decreased rapidly with a linear trend after treatment. After log transformation, the calculated half-life of AFP was 6.84 days. There was no more tumor arterial enhancement, and tumor size was decreased to 3.7 cm on day 42. PVT shrank gradually and localized to the right anterior branch at month 9. There was no recurrence of tumor at the end of follow-up in month 19. Typical serial changes of clinical parameters were demonstrated in this patient.

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Complete Response of Advanced Hepatocellular Carcinoma with Multiple Lung Metastases Treated with Sorafenib: A Case Report

Cited by 41 publications

References 26 publications

Impact of pretreatment serum cholinesterase level in unresectable advanced hepatocellular carcinoma patients treated with sorafenib

Impact of pretreatment serum cholinesterase level in unresectable advanced hepatocellular carcinoma patients treated with sorafenib

A Complete Response Induced by 21-day Sorafenib Therapy in a Patient with Advanced Hepatocellular Carcinoma

Serial changes of clinical parameters in a patient with advanced hepatocellular carcinoma with portal vein thrombosis achieving complete response after treatment with sorafenib

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