Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Achievement of complete response to nivolumab in a patient with advanced sarcomatoid hepatocellular carcinoma: A case report
Shu-Guang Zhu, Hai-Bo Li, Ze-Nan Yuan, Wei Liu, Qing Yang, Ying Cheng, Wen-Jing Wang, Guo-Ying Wang, Hua Li
Shu-Guang Zhu, Hai-Bo Li, Ze-Nan Yuan, Qing Yang, Guo-Ying Wang, Hua Li, Department of Hepatic Surgery and Liver Transplantation, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
Hai-Bo Li, Hua Li, Liver Transplant Branch of Organ Transplant Center, Organ Transplantation Institute of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
Ze-Nan Yuan, Wei Liu, Guo-Ying Wang, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
Ying Cheng, Wen-Jing Wang, Department of Medicine, OrigiMed Inc., Shanghai 201100, China
Author contributions: All authors contributed to the writing of the manuscript; Wang GY conceived the study; Li H provided clinical expertise; Liu W and Yang Q assisted in data collection; Cheng Y and Wang WJ analyzed the data and participated in revising and critically assessing the report; Zhu SG, LI H, Yuan ZN, and Wang GY provided expertise in molecular and targeted therapy; all the authors read and approved the final version of the manuscript.
Supported by The National 13th Five-Year Science and Technology Plan Major Projects of China, No. 2017ZX10203205-006-001.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Ying Cheng and Wen-Jing Wang are employees of OrigiMed Co., Ltd. No other potential conflicts of interest exist.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Guo-Ying Wang, MD, PhD, Doctor, Surgeon, Department of Hepatic Surgery and Liver Transplantation, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou 510000, Guangdong Province, China. wanggy3@126.com
Received: March 18, 2020
Peer-review started: March 18, 2020
First decision: May 28, 2020
Revised: July 6, 2020
Accepted: September 8, 2020
Article in press: September 8, 2020
Published online: October 15, 2020
BACKGROUND
Sarcomatoid hepatocellular carcinoma (SHC) is a rare subtype of hepatocellular carcinoma (HCC), with a high recurrence rate after surgery. In addition to limited effective treatment for the advanced stage of SHC, the prognosis of patients with this malignancy is worse than that of patients with conventional HCC.
CASE SUMMARY
We present the case of a 54-year-old man with SHC who underwent radical segmental hepatectomy, which relapsed 4 mo after surgery due to lymphatic metastasis in the porta hepatis. Although a second surgery was performed, new metastasis developed in the mediastinal lymph nodes. Therefore, sorafenib and lenvatinib were sequentially administered as first- and second-line systemic therapies, respectively. However, progressive disease was confirmed based on a recurrent hepatic lesion and new metastatic lesion in the abdominal cavity. Percutaneous transhepatic cholangial drainage was performed to alleviate the biliary obstruction. Because the tumor was strongly positive for programmed death-ligand 1, the patient was started on nivolumab. Imaging studies revealed that after two cycles of immunotherapy, the metastatic lesions decreased to undetectable levels.
CONCLUSION
The patient experienced continuous complete remission for 8 mo. Immune checkpoint inhibitors are useful for the treatment of advanced SHC.
Core Tip: Here, we report a rare case of advanced sarcomatoid hepatocellular carcinoma (SHC), which was successfully treated with the anti-programmed cell death 1 antibody. To the best of our knowledge, this is the first case report on the successful treatment of advanced SHC using immunotherapy.
