Two hepatectomy cases for initially unresectable hepatocellular carcinoma after achieving a radiological complete response to sequential therapy with lenvatinib and transcatheter arterial chemoembolization.
hepatocellular carcinoma
lenvatinib
sequential therapy
transcatheter arterial chemoembolization
Journal
Hepatology research : the official journal of the Japan Society of Hepatology
ISSN: 1386-6346
Titre abrégé: Hepatol Res
Pays: Netherlands
ID NLM: 9711801
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
16
04
2021
received:
06
01
2021
accepted:
08
05
2021
pubmed:
14
5
2021
medline:
14
5
2021
entrez:
13
5
2021
Statut:
ppublish
Résumé
We herein report two cases of locally advanced unresectable hepatocellular carcinoma (u-HCC) that were resected after achieving a radiological complete response to initially administered lenvatinib followed by transcatheter arterial chemoembolization (LEN-TACE sequential therapy). A 78-year-old woman and an 80-year-old man with HCC of Barcelona Clinic Liver Cancer classification stage C were treated for 15 and 14 months with lenvatinib, respectively. Both patients were subsequently treated with TACE, resulting in complete remission on imaging. The α-fetoprotein level in the woman and man decreased markedly from 9370 ng/ml to 46 ng/ml and from 6380 ng/ml to 3 ng/ml, respectively, leading to hepatectomy. A histopathological examination showed coagulative necrosis of the entire HCC in one case, while the other showed a small population of viable HCC cells. The results showed that LEN-TACE sequential therapy has a synergic effect and could be a promising option for locally advanced u-HCC.
Types de publication
Case Reports
Langues
eng
Pagination
1082-1086Informations de copyright
© 2021 The Japan Society of Hepatology.
Références
Kudo M, Finn RS, Qin S, Han K-H, Ikeda K, Piscaglia F, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018;391:1163-73.
Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc J-F, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378-90.
Matsuki R, Kawai K, Suzuki Y, Kogure M, Nakazato T, Naruge D, et al. Pathological complete response in conversion hepatectomy induced by lenvatinib for advanced hepatocellular carcinoma. Liver Cancer. 2020;9:358-60.
Kudo M. A new treatment option for intermediate-stage hepatocellular carcinoma with high tumor burden: initial lenvatinib therapy with subsequent selective TACE. Liver Cancer. 2019;8:299-311.
Sato N, Beppu T, Kinoshita K, Yuki H, Suyama K, Chiyonaga S, et al. Conversion hepatectomy for huge hepatocellular carcinoma with arterioportal shunt after chemoembolization and lenvatinib therapy. Anticancer Res. 2019;39:5695-701.
Tomonari T, Sato Y, Tanaka H, Tanaka T, Taniguchi T, Sogabe M, et al. Conversion therapy for unresectable hepatocellular carcinoma after lenvatinib. Medicine (Baltimore). 2020;99:e22782.
Makuuchi M, Kosuge T, Takayama T, Yamazaki S, Kakazu T, Miyagawa S, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9:298-304.
Kudo M, Ueshima K, Chan S, Minami T, Chishina H, Aoki T, et al. Lenvatinib as an initial treatment in patients with intermediate-stage hepatocellular carcinoma beyond up-to-seven criteria and Child-Pugh a liver function: a proof-of-concept study. Cancers. 2019;11:1084.
Yuan F, Chen Y, Dellian M, Safabakhsh N, Ferrara N, Jain RK. Time-dependent vascular regression and permeability changes in established human tumor xenografts induced by an anti-vascular endothelial growth factor/vascular permeability factor antibody. Proc Natl Acad Sci USA. 1996;93:14765-70.
Jain RK. Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science. 2005;307:58-62.
Shim JH, Park JW, Kim JH, An M, Kong SY, Nam BH, et al. Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients. Canc Sci. 2008;99:2037-44.
Ohya Y, Hayashida S, Tsuji A, Kuramoto K, Shibata H, Setoyama H, et al. Conversion hepatectomy for advanced hepatocellular carcinoma after right portal vein transection and lenvatinib therapy. Surg Case Rep. 2020;6:318.