Multimodal combination regimen for a patient with advanced huge hepatocellular carcinoma: a case report.

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY Translational gastroenterology and hepatology Pub Date : 2025-01-17 eCollection Date: 2025-01-01 DOI:10.21037/tgh-24-91
Shan Li, Zhen-Feng Zhou, Hao-Jian Long, Jia-Xin Yin, Hui-Zhong Wang, Jian-Fu Zhao
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Abstract

Background: Hepatocellular carcinoma (HCC) is a highly malignant tumor of the digestive system with a poor prognosis. Huge HCC, a subtype characterized by tumors measuring at least 10 cm in diameter, often presents with macrovascular invasion, satellite nodules, metastases, and other aggressive characteristics, posing significant challenges for treatment. The era of combined targeted therapy and immunotherapy has brought new hope to patients with advanced HCC. The development of innovative combination medication regimens for HCC is a current area of intense clinical research interest. We are trying to explore new combination therapies based on target-immunity combination therapy in the hope of better-benefiting patients with advanced huge HCC.

Case description: We present a patient with Barcelona Clinical Liver Cancer Stage C huge HCC who was treated with combined targeted therapy and immunotherapy as the primary therapeutic regimen, supplemented with tegafur long-term metronomic chemotherapy, as well as specialized adjuvant therapy such as thymosin, bisphosphonates, antiviral medication, and vitamin C supplementation. The tumor size was significantly reduced and microwave ablation was performed, after which, the patient was kept on the combination regimen, resulting in a partial response (PR), and maintaining PR without disease progression for 32 months.

Conclusions: The combination regimen may enhance advanced huge HCC treatment and provide a new multimodal drug strategy for HCC.

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多模式联合治疗晚期巨大肝癌1例。
背景:肝细胞癌(HCC)是一种高度恶性的消化系统肿瘤,预后不良。巨大HCC是一种以直径至少10cm的肿瘤为特征的亚型,通常表现为大血管侵袭、卫星结节、转移和其他侵袭性特征,给治疗带来了重大挑战。靶向治疗与免疫治疗联合的时代给晚期HCC患者带来了新的希望。HCC的创新联合用药方案的开发是当前临床研究的热点领域。我们正在尝试在靶向免疫联合治疗的基础上探索新的联合治疗方法,希望能更好地造福晚期巨大肝癌患者。病例描述:我们报告了一位巴塞罗那临床肝癌C期巨大HCC患者,以联合靶向治疗和免疫治疗为主要治疗方案,辅以替加氟长期节律化疗,以及胸腺肽、双膦酸盐、抗病毒药物和维生素C补充等专门辅助治疗。肿瘤大小明显减小,行微波消融治疗后,患者继续联合用药,部分缓解(PR), PR维持32个月无疾病进展。结论:联合用药方案可加强晚期巨量肝癌的治疗,为肝癌治疗提供一种新的多模式药物治疗策略。
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