Donafenib combined with HAIC and sintilimab for hepatocellular carcinoma with tumor thrombus in inferior vena cava and achieved complete remission: a case report

doi:10.11958/20221916

Tianjin Medical Journal ›› 2023, Vol. 51 ›› Issue (2): 203-206.doi: 10.11958/20221916

• Clinical Research • Previous Articles Next Articles

Donafenib combined with HAIC and sintilimab for hepatocellular carcinoma with tumor thrombus in inferior vena cava and achieved complete remission: a case report

ZHANG Wei¹(), GAO Wei²^,^△(), LIU Chen¹, LIU Xiaomeng¹, ZHANG Qin¹

1 Department of Hepatobiliary Surgery, Research Center for Prevention and Treatment of Liver Cancer; Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
2 Department of Interventional Therapy, Research Center for Prevention and Treatment of Liver Cancer; Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China

Received:2022-11-20 Revised:2022-12-05 Published:2023-02-15 Online:2023-02-24
Contact: ^△E-mail：doctorgao99@163.com

ZHANG Wei, GAO Wei, LIU Chen, LIU Xiaomeng, ZHANG Qin. Donafenib combined with HAIC and sintilimab for hepatocellular carcinoma with tumor thrombus in inferior vena cava and achieved complete remission: a case report[J]. Tianjin Medical Journal, 2023, 51(2): 203-206.

Abstract

Abstract:

Objective To investigate the effect of hepatic artery infusion chemotherapy combined with targeted and immunotherapy on hepatocellular carcinoma (HCC) with inferior vena cava tumor thrombus (IVCTT). Methods A case of hepatocellular carcinoma with tumor thrombus in the inferior vena cava (IVC) near the right atrium was treated with donafenib combined with hepatic artery infusion chemotherapy (HAIC) and sintilimab. The response of tumor treatment was evaluated by RECEST v1.1. The dynamic changes of alpha-fetoprotein (AFP) and PIVKA-Ⅱ were observed and the surgical procedure was introduced. Results After four cycles of treatment with donafenib combined with HAIC and sintilimab, the diameter of the tumor and the tumor thrombus in IVC were successfully reduced, and AFP was reduced to normal. Both tumor and tumor thrombus were completely removed by total hepatic vascular exclusion (THVE) with the IVC incision. Postoperative pathology showed complete remission of the tumor. Conclusion Donafenib combined with HAIC and sintilimab has a good tumor shrinking effect for HCC with IVCTT, and can be applied for conversion surgery for patients of HCC with IVCTT.

Key words: carcinoma, hepatocellular, donafenib, HAIC, conversion therapy, IVCTT

CLC Number:

R735.7

Figures/Tables 4

Fig.1 MRI features of a patient before and after tumor treatment

Fig.2 General observation of liver tumor and abdominal nodule during operation

Fig.3 During the operation the left liver and tumor were removed by whole hepatic vascular exclusion technique and tumor thrombus was resected completely

Fig.4 Pathological changes after operation

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Donafenib combined with HAIC and sintilimab for hepatocellular carcinoma with tumor thrombus in inferior vena cava and achieved complete remission: a case report

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