Hepatocellular carcinoma (HCC) is a cytotoxic chemotherapy-resistant tumor and most HCCs arise in a background of liver cirrhosis of various causes. Although the IMBrave150 trial showed remarkable advancements in the treatment of unresectable HCC with atezolizumab plus bevacizumab (AteBeva), therapeutic outcomes were unsatisfactory in more than half of the patients. Accordingly, many ongoing trials combine conventional modalities with new drugs such as immune checkpoint inhibitors for better treatment outcomes, and they are expected to benefit patients with limited responses to conventional treatment. Here, two patients with advanced stage HCC with preserved liver function and good performance status showed partial response after treatment with combination or sequential therapy of AteBeva, hepatic arterial infusion chemotherapy, radiation therapy, and transarterial chemoembolization. These findings indicate the efficacy of multidisciplinary treatment against advanced HCC. Additional studies are required to establish optimal treatment strategies.
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Complications of immunotherapy in advanced hepatocellular carcinoma Young-Gi Song, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim Journal of Liver Cancer.2024; 24(1): 9. CrossRef
Higher objective responses by hepatic arterial infusion chemotherapy following atezolizumab and bevacizumab failure than when used as initial therapy in hepatocellular carcinoma: a retrospective study Jae-Sung Yoo, Ji Hoon Kim, Hee Sun Cho, Ji Won Han, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Suho Kim, Jung Suk Oh, Ho Jong Chun, Pil Soo Sung Abdominal Radiology.2024; 49(9): 3127. CrossRef
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Hepatocellular carcinoma is one of the most important malignancies in Korea with high mortality rates. Although current
guidelines define treatment algorithm by performance status, underlying liver function, size and number of hepatocellular
carcinoma, those are not fully reflect the complexities of patients’ characteristics and recently advanced available therapeutic
options. Treatment can be optimized by available therapeutic options based on the patients’ characteristics. Because of the
heterogeneity in presentation among patients, it is now widely accepted that management of hepatocellular carcinoma requires
multimodality and multidisciplinary treatment approaches involving hepatologists, surgeons, interventional radiologists, and
radiation oncologists. These approaches are important in improving the survival of patients with hepatocellular carcinoma.
Cure by single modality for advanced hepatocellular carcinoma (HCC) is difficult. Therefore, multidisciplinary approaches are
needed to get a better outcome for advanced HCC. In this paper, we report a case of advanced HCC treated with curative surgical
resection after downstaging by hepatic arterial infusion chemotherapy (HAIC). A 50-year-old male patient had a maximum 16.0
cm sized HCC in the right lobe. He achieved a partial response after 2 cycles of HAIC with 5-FU (750 mg/m2) and cisplatin (25
mg/m2). After completion of 6 cycles, he received a curative right hepatectomy and the histopathology revealed 95% of tumor
necrosis. He is under follow-up without recurrence at 14 months of surgery. This case suggests that surgery after downstaging by
HAIC may provide good clinical outcome in advanced HCC.