Rapid regression of advanced hepatocellular carcinoma associated with elevation of des-gamma-carboxy prothrombin after short-term treatment with sorafenib - a report of two cases.
Rapid regression of advanced hepatocellular carcinoma associated with elevation of des-gamma-carboxy prothrombin after short-term treatment with sorafenib - a report of two cases.
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DOI：
10.1159/000319831
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发表时间：
2010-08-12
影响因子：
0.8
通讯作者：
Koizumi W
中科院分区：
文献类型：
--
作者：
Nakazawa T;Hidaka H;Shibuya A;Koizumi W
索拉非尼是第一个对晚期肝细胞癌（HCC）有效的分子靶向药物，可延长患者的生存期。然而，完全缓解的情况非常罕见，并且此前尚未报道索拉非尼短期治疗后 HCC 快速消退。我们描述了 2 名晚期多发性 HCC 患者，他们分别接受了 1 周或 2 周的短期索拉非尼治疗。由于索拉非尼的不良事件肝衰竭的发生，无法进行更长时间的治疗。 HCC 迅速消退，尽管经过短期治疗，两名患者均获得部分缓解 (PR)。此外，两名患者的早期脱-γ-羧基凝血酶原（DCP）暂时升高，但甲胎蛋白没有升高。即使经过短期治疗，索拉非尼也能诱导晚期 HCC 快速消退，并且两名患者的 HCC 初始反应相同。由于在 PR 患者中观察到 DCP 早期升高，因此 DCP 可能是抗肿瘤反应的预测生物标志物。需要进一步的研究来阐明索拉非尼有效性的机制，包括 DCP 的改变。
Sorafenib is the first molecular-targeted agent that is effective for advanced hepatocellular carcinoma (HCC), with prolongation of survival. However, a complete response is very rare, and rapid regression of HCC after short-term treatment with sorafenib has not been reported previously. We describe 2 patients with advanced multiple HCC who received sorafenib for short periods of 1 or 2 weeks, respectively. Longer treatment was precluded by the development of hepatic failure as an adverse event of sorafenib. HCC rapidly regressed, and both patients had a partial response (PR), despite short-term treatment. Furthermore, an early elevation of des-gamma-carboxy prothrombin (DCP) was temporarily seen in both patients, with no elevation of alpha-fetoprotein. Sorafenib can induce rapid regression of advanced HCC even after short-term treatment, and the initial response of HCC was identical in both patients. Since early elevation of DCP was observed in our patients with PR, DCP might be a predictive biomarker of anti-tumor response. Further studies are required to clarify the mechanisms underlying the effectiveness of sorafenib, including the alteration of DCP.
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