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A case of advanced HCC treated with lenvatinib after hepatic arterial infusion chemotherapy combined with radiation therapy treatment for portal vein tumor thrombosis in the main trunk

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Abstract

We report a 46-year-old male patient with functional liver damage due to hepatitis B virus infection. A 12 cm hepatocellular carcinoma (HCC) in the left lobe and portal venous tumor thrombosis (PVTT) with vp4 (portal vein tumor thrombosis in the main trunk) were detected by computed tomography (CT). He underwent hepatic arterial infusion chemotherapy (HAIC) with cisplatin 100 mg for HCC and received radiation therapy (39 Gy/13 Fr) for PVTT with vp4. Follow-up CT showed reduction of HCC and reduced PVTT volume after 1 month of treatment. He then initiated lenvatinib therapy at 12 mg/day. One month later, follow-up CT showed no change in HCC size and a reduction in PVTT volume. Two months after initiating lenvatinib, follow-up CT showed no change in HCC, but further reduction in contrast effect and volume of PVTT. Three months after HAIC, he underwent drug-eluting-bead transcatheter arterial chemoembolization (DEB-TACE) with 100 mg of cisplatin (CDDP) for the HCC. After DEB-TACE, he received 12 mg/day with 5-days-on/2-days-off due to vomiting. One month after DEB-TACE, blood evaluation showed decreased tumor markers, and CT revealed that the HCC had grown slightly with no change in PVTT. Five months after HAIC, he underwent DEB-TACE with 100 mg of cisplatin for the HCC. A total of 150 days have passed since the start of lenvatinib treatment, and his Child–Pugh A status has been maintained.

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Authors and Affiliations

  1. Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan

    Yumi Kosaka, Tomokazu Kawaoka, Hiroshi Aikata, Yosuke Suehiro, Kenji Yamaoka, Yuwa Ando, Maiko Namba, Yasue Takeuchi, Yasutomo Fujii, Shinsuke Uchikawa, Kenichiro Kodama, Kazuki Oya, Kei Morio, Hatsue Fu**o, Takashi Nakahara, Eisuke Murakami, Masami Yamauchi, Masataka Tsuge, Akira Hiramatsu, Michio Imamura & Kazuaki Chayama

  2. Diagnostic Radiology, Hiroshima University Hospital, Hiroshima, Japan

    Yasutaka Baba & Kazuo Awai

  3. Therapeutic Radiology, Institute and Graduate School of Biomedical Science, Hiroshima University Hospital, Hiroshima, Japan

    Tomoki Kimura & Yasushi Nagata

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  1. Yumi Kosaka
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  2. Tomokazu Kawaoka
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Corresponding author

Correspondence to Hiroshi Aikata.

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Conflict of interest

Kazuaki Chayama has received honoraria from Bristol-Myers Squibb, MSD K.K., AbbVie Inc., Gilead Sciences, Dainippon Sumitomo Pharma and Mitsubishi Tanabe and research funding from Dainippon Sumitomo Pharma, MSD K.K, AbbVie Inc, Eisai, Toray, Otsuka, Chugai, Takeda, Roche, Mitsubishi Tanabe and Bristol-Byers Squibb. Michio Imamura has received research funding from Bristol-Myers Squibb. Other authors declare no competing interests.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Kosaka, Y., Kawaoka, T., Aikata, H. et al. A case of advanced HCC treated with lenvatinib after hepatic arterial infusion chemotherapy combined with radiation therapy treatment for portal vein tumor thrombosis in the main trunk. Clin J Gastroenterol 13, 839–843 (2020). https://doi.org/10.1007/s12328-020-01093-9

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  • DOI: https://doi.org/10.1007/s12328-020-01093-9

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