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Narita H, Kawaratani H, Shibamoto A, Takeda S, Ozutsumi T, Tsuji Y, Fujinaga Y, Kitagawa K, Nishimura N, Hokuto D, Sho M, Yoshiji H. Long-term survival with sorafenib-based multidisciplinary treatment for Vp4 hepatocellular carcinoma: a case report. Clin J Gastroenterol 2022; 15:953-959. [DOI: 10.1007/s12328-022-01667-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/20/2022] [Indexed: 02/07/2023]
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Fansiwala K, Saltiel J, Poles M. Acute Kidney Injury Presenting as Hepatorenal Syndrome in the Setting of Glecaprevir/Pibrentasvir Treatment for Hepatitis C. ACG Case Rep J 2021; 8:e00587. [PMID: 33997092 DOI: 10.14309/crj.0000000000000587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 12/04/2020] [Indexed: 12/14/2022] Open
Abstract
A 65-year-old man with chronic hepatitis C virus and hepatocellular carcinoma, after surgical resection and chemotherapy, was started on a regimen of glecaprevir and pibrentasavir for treatment of his hepatitis C virus. Ten days later, he developed hepatotoxicity with subsequent progression to hepatorenal syndrome (HRS). On discontinuation of glecaprevir/pibrentasavir and initiation of HRS treatment, he had improvement in his renal and hepatic function. Although there have been recent safety concerns surrounding hepatocellular injury secondary to glecaprevir/pibrentasavir, this is the first case report of HRS secondary to severe hepatotoxicity induced by glecaprevir/pibrentasavir.
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Kim DH, Cho E, Cho SB, Choi SK, Kim S, Yu J, Koh YI, Sim DW, Jun CH. Complete response of hepatocellular carcinoma with right atrium and pulmonary metastases treated by combined treatments (a possible treatment effect of natural killer cell): A case report and literature review. Medicine (Baltimore) 2018; 97:e12866. [PMID: 30334999 PMCID: PMC6211840 DOI: 10.1097/md.0000000000012866] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
RATIONALE Hepatocellular carcinomas (HCCs) with metastases to the right atrium (RA) and lungs are rare, with a poor prognosis. Furthermore, the treatment outcomes in patients with advanced HCCs remain unsatisfactory. PATIENT CONCERNS A 46-year-old man presented to our hospital for dyspnea on exertion and abdominal pain. DIAGNOSES HCC and extra-hepatic metastases to the lung and RA. INTERVENTIONS Multidisciplinary treatment including radiotherapy (RT), transarterial chemoembolization (TACE), and sorafenib. During a follow-up evaluation computed tomography, he experienced a radio-contrast-induced anaphylaxis. After the event, treatment such as RT, TACE, and sorafenib were continued. OUTCOMES His tumor burden decreased, finally leading to a complete response as per the modified Response Evaluation Criteria in Solid Tumors. The patient is still alive, 30 months after the episode. Subsequent blood tests showed increased natural killer (NK) cell activity, which was significantly higher than that seen in other age-matched HCC patients with an identical stage of the tumor, receiving sorafenib. This suggests that the increase in NK cells induced by anaphylaxis influenced the tumor burden. LESSONS We report here a rare case of long-term survival of an HCC patient with multiple metastases treated with multidisciplinary modalities, in which high NK cell activity was observed after a radio-contrast-induced anaphylactic reaction during follow-up investigations.
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Affiliation(s)
| | | | | | | | | | - Jieun Yu
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | - Young-Il Koh
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | - Da Woon Sim
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea
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Lee TY, Lin CC, Chen CY, Wang TE, Lo GH, Chang CS, Chao Y. Combination of transcatheter arterial chemoembolization and interrupted dosing sorafenib improves patient survival in early-intermediate stage hepatocellular carcinoma: A post hoc analysis of the START trial. Medicine (Baltimore) 2017; 96:e7655. [PMID: 28906355 PMCID: PMC5604624 DOI: 10.1097/md.0000000000007655] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVE The survival benefit of treatment for unresectable hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization (TACE) combined with sorafenib remains uncertain. We compared the survival of patients treated with TACE and sorafenib with that of patients treated with TACE alone. METHODS This was a post hoc analysis of the Study in Asia of the Combination of TACE with Sorafenib in Patients with HCC (START) trial. All patients who received TACE and interrupted dosing of sorafenib for early or intermediate-stage HCC in Taiwan from 2009 to 2010 were recruited into the TACE and sorafenib group. They were randomly matched 1:1 by age, sex, Child-Pugh score, tumor size, tumor number, and tumor stage with patients from Taichung Veterans General Hospital in Taiwan who received TACE alone and who fulfilled the selection criteria of the START trial during the same time period (control group). Patient survival [cumulative incidence and hazard ratio (HR)] of the 2 groups were analyzed and compared. RESULTS The baseline characteristics of the 36 patients in each group were similar. Tumor response rates were significantly better in the TACE and sorafenib group (P < .04). Overall survival of the TACE and sorafenib group was also significantly better than that of the control (TACE alone) group over the 2 years [78%, 95% confidence interval (95% CI) 64-91 vs 49, 95% CI 32-66; P = .012]. In the multivariate regression analysis, TACE and sorafenib was found to be independently associated with a decreased risk of mortality (HR 0.33, 95% CI 0.12-0.89; P = .015). Multivariate stratified analyses verified this association in each patient subgroup (all HR < 1.0). CONCLUSION With a high patient tolerance to an interrupted sorafenib dosing schedule, the combination of TACE with sorafenib was associated with improved overall survival in early-intermediate stage HCC when compared with treatment with TACE alone.
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Affiliation(s)
- Teng-Yu Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital
- Department of Medicine, Chung Shan Medical University, Taichung
| | - Chen-Chun Lin
- Division of Hepatology, Liver Research Unit, Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital–Chang Gung University, Linkou
| | - Chiung-Yu Chen
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | | | - Gin-Ho Lo
- Department of Medical Research, E-Da Hospital, School of Medicine for International Students, I-Shou University, Kaohsiung
| | - Chi-Sen Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital
| | - Yee Chao
- Department of Oncology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
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Nakano N, Kawaoka T, Aikata H, Honda F, Nakamura Y, Morio K, Hatooka M, Fukuhara T, Kobayashi T, Hiramatsu A, Imamura M, Kawakami Y, Takahashi S, Chayama K. Complete response to short-term sorafenib treatment alone for hepatocellular carcinoma with bone, lymph node, and peritoneum metastases. Hepatol Res 2016; 46:1402-1408. [PMID: 26988002 DOI: 10.1111/hepr.12698] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/03/2016] [Accepted: 03/08/2016] [Indexed: 02/08/2023]
Abstract
We report a 60-year-old male patient who developed extrahepatic metastases in bone, peritoneum, and lymph nodes (confirmed by computed tomography and positron emission tomography-computed tomography) after hepatectomy for hepatocellular carcinoma. He was treated with sorafenib (800 mg/day) but developed grade 3 hand-foot syndrome. He continued to be treated with sorafenib but at a lower dose (400 mg/week). The response to sorafenib therapy was graded as complete response at 6 months by the Response Evaluation Criteria in Solid Tumors. Sorafenib was continued for 8 months and the patient remained in complete response for 11 months. Further reporting of similar cases should help design treatment strategies and evaluate predictors of the response to sorafenib therapy.
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Affiliation(s)
- Norihito Nakano
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Fumi Honda
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Yuki Nakamura
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Kei Morio
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Masahiro Hatooka
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Takayuki Fukuhara
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Tomoki Kobayashi
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Akira Hiramatsu
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Michio Imamura
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Yoshiiku Kawakami
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Shoichi Takahashi
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Medicine and Molecular Science, Division of Frontier Medical Science, and, Hiroshima University, Hiroshima, Japan
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Arslanoglu A, Seyal AR, Sodagari F, Sahin A, Miller FH, Salem R, Yaghmai V. Current Guidelines for the Diagnosis and Management of Hepatocellular Carcinoma: A Comparative Review. AJR Am J Roentgenol 2016; 207:W88-98. [DOI: 10.2214/ajr.15.15490] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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