Case Report: Complete Response of Primary Massive Hepatocellular Carcinoma to Anti-Programmed Death Ligand-1 Antibody Following Progression on Anti-Programmed Death-1 Antibody

Liu, Gang; Zhou, Wen-Xuan; Li, Xiaoli; Guo, Lijie; He, Tingting; Juan, Zhao; Gong, Lan

doi:10.3389/fimmu.2021.712351

Cited by 6 publications

(1 citation statement)

References 27 publications

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“…Liu et al reported a case of massive HCC with portal hepatic vein tumor thrombus and ALN metastases. The patient received atezolizumab plus bevacizumab and experienced a CR after three cycles of treatment (20). However, an optimal immunotherapeutic strategy for HCC has not been found.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Complete response after tislelizumab treatment in a hepatocellular carcinoma patient with abdominal lymph node metastasis

et al. 2023

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BackgroundAbdominal lymph node (ALN) metastasis is associated with a poor prognosis in patients with hepatocellular carcinoma (HCC) because of the limited number of effective therapeutic options available. Immunotherapy with immune checkpoint inhibitors, such as those targeting programmed death receptor-1 (PD-1), have produced encouraging results in patients with advanced HCC. Here, we report a complete response (CR) in a patient with advanced HCC and ALN metastasis after combination treatment with tislelizumab (a PD-1 inhibitor) and locoregional therapy.Case summaryA 58-year-old man with HCC experienced progressive disease with multiple ALN metastases after undergoing transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA), and laparoscopic resection. Because the patient did not wish to receive systemic therapy, including chemotherapy and targeting therapy, we prescribed tislelizumab (as a single immunotherapeutic agent) together with RFA. After four tislelizumab treatment cycles, the patient achieved a CR without tumor recurrence for up to 15 months.ConclusionTislelizumab monotherapy can be effectively used to treat advanced HCC with ALN metastasis. Moreover, the combination of locoregional therapy and tislelizumab is likely to further increase therapeutic efficacy.

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Section: Discussionmentioning

confidence: 99%

Case Report: Complete response after tislelizumab treatment in a hepatocellular carcinoma patient with abdominal lymph node metastasis

et al. 2023

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Pembrolizumab

2021

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A woman in her early 50s [exact age not stated] acquired resistance to pembrolizumab while being treated for primary massive hepatocellular carcinoma (HCC).The woman presented at a local hospital with right upper abdominal pain at the age of 49 years. Therefore, she was admitted to a hospital in China for further examination on 21 August 2018. Her medical history was significant for hepatitis-B for many years without regular antiviral therapy or other treatments. During hospitalisation, primary massive HCC with portal hepatic vein tumor thrombus formation was considered along with renal cyst and liver cirrhosis. On 29 August 2018, she underwent right hepatic resection to obtain the remnant liver volume. She was finally diagnosed with primary massive HCC stage-C, stage IIIA with portal hepatic vein tumor thrombus. One month after the surgery, the laboratory findings revealed multiple nodules in the liver and tumour thrombus in the right hepatic vein and the left portal vein. On 21 September 2018, she started receiving treatment with sorafenib. Additionally, she underwent transarterial chemoembolisation (TACE) three times between September 2018 and November 2018. On 2 November 2018, the laboratory findings revealed disease progression and the development of new pulmonary metastases. Therefore, she started receiving treatment with pembrolizumab 100mg [route not stated] every 3 weeks concomitantly with lenvatinib on 2 November 2018. The laboratory examination in February 2019 revealed that the pulmonary nodules had disappeared and alpha-fetoprotein (AFP) values returned to the normal range. Thereafter, she achieved a complete response. In February 2020, her AFP level increased. On 11 March 2020 and 29 April 2020 (in her early 50s), the AFP levels were found to be elevated. The MRI showed abdominal lymph node metastases, indicating disease progression. As a result, acquired resistance to pembrolizumab was considered.The woman's therapy with pembrolizumab and lenvatinib was stopped. On 2 June 2020, she started receiving atezolizumab and bevacizumab. On 10 July 2020 and 2 August 2020, she received atezolizumab and bevacizumab followed by directional radiotherapy. In October 2020, atezolizumab and bevacizumab therapies were stopped due to side effects [details not stated]; however, a complete response was achieved. On follow-up in December 2020, she was found to be in good health.

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