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CASE REPORT
Treatment of inoperable hepatocellular carcinoma with immunotherapy
  1. Sean P Tighe1,
  2. Umair Iqbal2,
  3. Christopher T Fernandes1 and
  4. Aijaz Ahmed3
  1. 1 Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
  2. 2 Division of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
  3. 3 Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California, USA
  1. Correspondence to Dr Umair Iqbal, umairiqbal_dmc{at}hotmail.com

Abstract

In the USA, mortality associated with hepatocellular carcinoma (HCC) continues to rise. Globally, HCC is the third most common cause of cancer-related death. In early stages of HCC, hepatic resection or liver transplantation are the preferred treatment options with a high probability of recurrence-free postoperative course. However, ineffective screening of chronic liver diseases in high-risk populations, poor linkage to care and suboptimal HCC surveillance has led to increasing rates of late-stage HCC at clinical presentation or diagnosis amenable only to palliative and experimental treatment options. Our case is a 66-year-old man with chronic hepatitis C virus infection complicated by cirrhosis and inoperable HCC which was non-responsive to selective intrahepatic trans-arterial chemoembolisation by interventional radiology. Therefore, he was treated with nivolumab immunotherapy and demonstrated normalisation of previously elevated alpha-fetoprotein levels suggestive of at least a partial response to immunotherapy. No adverse events related to nivolumab immunotherapy were encountered.

  • hepatocellular carcinoma
  • HCC
  • nivolumab
  • sorafenib
  • immunotherapy
  • nonalcoholic fatty liver disease
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Footnotes

  • Contributors SPT was involved in planning, writing, editing and finalising the manuscript. UI was involved in literature search, writing the case and discussion. CTF was involved in planning, writing, editing and finalising the manuscript. AA was involved in a patient care and was involved in writing up the case, finalising the discussion and background. All authors agreed with the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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