Lenvatinib + transarterial chemoembolization + PD-1 antibody in the treatment of hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation: four case reports_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xiaoyun ¹ , ZHU Xinrui ¹ , PENG Wei ¹ , LIU Chang ¹ , LI Chuan ¹ , LI Qiu ² , CHEN Weixia ³ , LI Zhiping ⁴ , LU Qiang ⁵ , LU Wusheng ¹ , YAN Lünan ¹ , YANG Jiayin ¹ ,  WEN Tianfu ¹

1. Department of Liver Surgery/Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
4. Department of Abdominal Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
5. Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WEN Tianfu, Email: wentianfu@scu.edu.cn

Keywords：

advanced hepatocellular carcinoma; main portal vein tumor thrombus; combination therapy; lenvatinib; transarterial chemoembolization; programmed cell death protein-1 antibody

DOI：

10.7507/1007-9424.202201047

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Objective To summarize the effect of lenvatinib + transarterial chemoembolization (TACE) + programmed cell death protein-1 (PD-1) antibody in the treatment of hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation. Methods In this study, we reported the clinical data of four patients with hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation who received conversion therapy with lenvatinib combined with TACE and PD-1 antibody in West China Hospital. Results Among the four patients, two patients achieved complete response and two achieved partial response; tumor markers were significantly decreased after combination treatment. However, all four patients failed to undergo hepatectomy. Conclusions Lenvatinib + TACE + PD-1 antibody is effective for hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation. However, there are still many problems worthy of further discussion.

Citation： ZHANG Xiaoyun, ZHU Xinrui, PENG Wei, LIU Chang, LI Chuan, LI Qiu, CHEN Weixia, LI Zhiping, LU Qiang, LU Wusheng, YAN Lünan, YANG Jiayin, WEN Tianfu. Lenvatinib + transarterial chemoembolization + PD-1 antibody in the treatment of hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation: four case reports. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(5): 618-622. doi: 10.7507/1007-9424.202201047 Copy

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1. 张晓赟, 朱心睿, 彭伟, 等. 经肝动脉化疗栓塞+仑伐替尼+PD-1单抗在中晚期不可切除肝癌转化切除中的安全性和有效性的前瞻性队列研究: 初步报告. 中国普外基础与临床杂志, 2022, 29（1）: 39-45.
2. 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范（2019年版）. 传染病信息, 2020, 33 (6): 481-500.
3. Kokudo T, Hasegawa K, Matsuyama Y, et al. Survival benefit of liver resection for hepatocellular carcinoma associated with portal vein invasion. J Hepatol, 2016, 65(5): 938-943.
4. Zhang XP, Gao YZ, Chen ZH, et al. An Eastern hepatobiliary surgery hospital/portal vein tumor thrombus scoring system as an aid to decision making on hepatectomy for hepatocellular carcinoma patients with portal vein tumor thrombus: a multicenter study. Hepatology, 2019, 69(5): 2076-2090.
5. Wei X, Jiang Y, Zhang X, et al. Neoadjuvant three-dimensional conformal radiotherapy for resectable hepatocellular carcinoma with portal vein tumor thrombus: a randomized, open-label, multicenter controlled study. J Clin Oncol, 2019, 37(24): 2141-2151.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Lenvatinib + transarterial chemoembolization + PD-1 antibody in the treatment of hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation: four case reports

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