Treatment of metastatic hepatocellular carcinoma with lenvatinib. Case report and literature review

Cover Page

Cite item

Full Text

Abstract

Hepatocellular carcinoma (HCC) or liver cancer is the most common primary malignant tumor of the liver, which is characterized on the first place by a poor prognosis. HCC was diagnosed in 92 patients (62.6%) in 2019 and the period from January to April 2020 in the Republic of Bashkortostan, and among them, 68.47% had stage IV cancer. International professional guidelines suggest screening for early HCC detection. Systemic drug therapy is the treatment of choice for inoperable HCC according to professional guidelines. Inhibition of the VEGF pathway is one of the current methods of therapy for advanced HCC. Lenvatinib is a tyrosine kinase inhibitor for the treatment of advanced HCC that is not subject to local interventions. This article provides a description of a clinical case of successful treatment of a 67-year-old patient with advanced hepatocellular carcinoma. He was appointed for targeted therapy with lenvatinib for HCC that was not subject to local interventions, which led to long-term stabilization. There was a positive trend in the patient’s condition from the first weeks of therapy. The working capacity was restored. The therapy showed a satisfactory tolerability profile.

About the authors

Konstantin V. Menshikov

Bashkir State Medical University; Republican Clinical Oncological Dispensary

Author for correspondence.
Email: kmenshikov80@bk.ru
ORCID iD: 0000-0003-3734-2779

Cand. Sci. (Med.)

Russian Federation, Ufa; Ufa

Aleksandr V. Sultanbaev

Republican Clinical Oncological Dispensary

Email: rkodrb@yandex.ru
ORCID iD: 0000-0003-0996-5995

Cand. Sci. (Med.)

Russian Federation, Ufa

Kamila T. Akhmetgareeva

Bashkir State Medical University

Email: dr.camilaakhmetgareeva@gmail.com
ORCID iD: 0000-0003-0773-1239

Graduate Student

Russian Federation, Ufa

Danila O. Lipatov

Bashkir State Medical University

Email: lipatov911@gmail.com
ORCID iD: 0000-0002-3193-9008

Student

Russian Federation, Ufa

References

  1. Torre LA, Siegel RL, Elizabeth M. Ward and Ahmedin Jemal. Global Cancer Incidence and Mortality Rates and Trends – An Update. Cancer Epidemiol Biomarkers Prev 2016; 25: 16–27.
  2. Jemal A, Ward EM, Johnson CJ, et al. Annual Report to the Nation on the Status of Cancer, 1975–2014, Featuring Survival. J Natl Cancer Inst 2017; 109 (9).
  3. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394–424.
  4. Состояние онкологической помощи населению России в 2019 году. Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахазадовой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2020 [The state of cancer care for the population of Russia in 2019. Ed. AD Kaprina, VV Starinsky, AO Shahazadova. MNIOI them. PA Herzen is a branch of the Federal State Budgetary Institution «National Medical Research Center of Radiology» of the Ministry of Health of Russia. Moscow, 2020 (in Russian)].
  5. Ахметгареева К.Т., Липатов О.Н., Меньшиков К.В., Султанбаев А.В. Заболеваемость первичным раком печени в Республике Башкортостан. В кн.: Белые ночи 2020. Тезисы VI Петербургского международного онкологического форума. СПб., 2020; с. 22 [Akhmetgareeva KT, Lipatov ON, Menshikov KV, Sultanbaev AV. The incidence of primary liver cancer in the Republic of Bashkortostan. In the book: White Nights 2020. Abstracts of the VI St. Petersburg International Oncological Forum. Saint Petersburg, 2020; p. 22 (in Russian)].
  6. Tseng C-H, Hsu Y-C, Chen T-H, et al. Hepatocellular carcinoma incidence with tenofovir versus entecavir in chronic hepatitis B: A systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 5: 1039–52.
  7. Carrat F, Fontaine H, Dorival C, et al. Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: A prospective cohort study. Lancet 2019; 393: 1453–64.
  8. Kubota N, Fujiwara N, Hoshida Y. Clinical and Molecular Prediction of Hepatocellular Carcinoma Risk. J Clin Med 2020; 9: 3843.
  9. Pazgan-Simon M, Simon KA, Jarowicz E, et al. Hepatitis B virus treatment in hepatocellular carcinoma patients prolongs survival and reduces the risk of cancer recurrence. Clin Exp Hepatol 2018; 4 (3): 210–6. doi: 10.5114/ceh.2018.78127
  10. Бредер В.В., Лактионов К.К., Давыдов М.М. Лекарственное лечение гепатоцеллюлярного рака: практические вопросы и решения. Медицинский совет. 2017; 14: 11–23 [Breder VV, Laktionov KK, Davydov MM. Lekarstvennoe lechenie gepatotselliuliarnogo raka: prakticheskie voprosy i resheniia. Meditsinskii sovet. 2017; 14: 11–23 (in Russian)]. doi: 10.21518/2079-701X-2017-14-11-23
  11. Kieran MW, Kalluri R, Cho YJ. The VEGF pathway in cancer and disease: responses, resistance, and the path forward. Cold Spring Harb Perspect Med. 2012; 2.
  12. Carlomagno F, Anaganti S, Guida T, et al. BAY 43-9006 inhibition of oncogenic RET mutants. J Natl Cancer Inst 2006; 98 (5): 326–34.
  13. Llovet JJM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359 (4): 378–390.
  14. Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet 2018; 391: 1163–73.
  15. Vogel A, Qin S, Kudo M, et al. Health-Related Quality of Life (HRQOL) and Disease Symptoms in Patients with Unresectable Hepatocellular Carcinoma (HCC) Treated with Lenvatinib (LEN) or Sorafenib (SOR). Ann Oncol 2017; 28 (Suppl. 5): v209–v268. doi: 10.1093/annonc/mdx369.002.

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. The design of the REFLECT study.

Download (165KB)
3. Fig. 2. The primary endpoint: The Kaplan-Meier-method for the analyzation of overall survival (adapted from M. Kudo et al., 2018 [14]).

Download (17KB)
4. Fig. 3. Computed tomography (CT) scan of the abdomen, the beginning of contrast-injection.

Download (14KB)
5. Fig. 4. Venous phase abdominal CT. The sum of the longest diameter of the target lesions is 203 mm.

Download (16KB)
6. Fig. 5. Abdominal CT scans 6 months after starting lenvatinib therapy, the beginning of contrast-injection.

Download (11KB)
7. Fig. 6. Venous phase abdominal CT scans 6 months after starting lenvatinib therapy. The sum of the longest diameter of the target lesions is 184 mm.

Download (13KB)

Copyright (c) 2021 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies