Favorable Response of Metastatic Hepatocellular Carcinoma to Treatment with Trans-arterial Radioembolization Followed by Sorafenib and Nivolumab
Favorable Response of Metastatic Hepatocellular Carcinoma to Treatment with Trans-arterial Radioembolization Followed by Sorafenib and Nivolumab
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DOI：
10.7759/cureus.4083
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发表时间：
2019-02-16
影响因子：
1.2
通讯作者：
Campbell, Garth S.
中科院分区：
文献类型：
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作者：
Adcock, Charles S.;Puneky, Louis V.;Campbell, Garth S.
Y-90微球经动脉放射性栓塞（TARE）是一种血管内、肝脏定向治疗，适用于治疗局部晚期肝细胞癌（HCC），通常作为缩小肿瘤大小和桥接患者切除或肝移植的一种方法。Opdivo（R）或nivolumab是一种程序性细胞死亡蛋白1（PD-1）抑制剂，是一种免疫抑制剂，于2017年9月批准用于治疗既往接受索拉非尼治疗的HCC患者。我们报告一位肝细胞癌合并左右门静脉侵犯、骨转移及可能的肺转移的病例。患者在用TARE、索拉非尼和纳武单抗连续治疗后显示出显著应答。我们的病例表明，TARE、索拉非尼和纳武单抗可能对HCC的免疫应答具有协同作用。
Trans-arterial radioembolization (TARE) with Y-90 microspheres is an endovascular, liver-directed therapy suitable for treatment of locally advanced hepatocellular carcinoma (HCC) often as a way to reduce tumor size and bridge patients to resection or liver transplant. Opdivo (R), or nivolumab, a programmed cell death protein 1 (PD-1) inhibitor, is an immunotherapeutic drug approved in September 2017 for the treatment of HCC in patients who have received prior sorafenib. We report on a patient with hepatocellular carcinoma with right and left portal vein involvement, bony metastasis, and possible lung metastasis. The patient showed a significant response following consecutive treatment with TARE, sorafenib, and nivolumab. Our case suggests that TARE, sorafenib, and nivolumab may have a synergistic effect on the immune response to HCC.