The excellent antitumor effect of apatinib alone as second-line therapy in a patient with sorafenib-refractory hepatocellular carcinoma: A case report

Hepatocellular carcinoma (HCC) is a highly invasive cancer associated with high mortality rates. Although sorafenib is currently recommended as standard treatment for advanced HCC, its treatment efficacy is limited. Effective treatments for patients with advanced HCC that progresses on or after sora...

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Published inMedicine (Baltimore) Vol. 97; no. 25; p. e11214
Main Authors Zhu, Hong, Ma, Xiaojun, Zhao, Yaqin, Duo, Ji
Format Journal Article
LanguageEnglish
Published United States Wolters Kluwer Health 01.06.2018
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Abstract Hepatocellular carcinoma (HCC) is a highly invasive cancer associated with high mortality rates. Although sorafenib is currently recommended as standard treatment for advanced HCC, its treatment efficacy is limited. Effective treatments for patients with advanced HCC that progresses on or after sorafenib treatment or patients who are intolerant of sorafenib remain an unmet medical need. We report an advanced HCC patient with many lung metastases who failed sorafenib treatment. Sorafenib refractory HCC patient with a large number of lung metastases. The apatinib alone was used as second line therapy. The patient achieved partial response (PR) soon after the treatment, which was maintained for approximately 1 year. During the entire process, the lung metastases continued to diminish. Finally, only a few lesions remained LESSONS:: Apatinib alone may be a good second-line therapy for advanced HCC patients who are refractory to sorafenib. However, further investigation in future prospective clinical studies is warranted.
AbstractList Hepatocellular carcinoma (HCC) is a highly invasive cancer associated with high mortality rates. Although sorafenib is currently recommended as standard treatment for advanced HCC, its treatment efficacy is limited. Effective treatments for patients with advanced HCC that progresses on or after sorafenib treatment or patients who are intolerant of sorafenib remain an unmet medical need. We report an advanced HCC patient with many lung metastases who failed sorafenib treatment. Sorafenib refractory HCC patient with a large number of lung metastases. The apatinib alone was used as second line therapy. The patient achieved partial response (PR) soon after the treatment, which was maintained for approximately 1 year. During the entire process, the lung metastases continued to diminish. Finally, only a few lesions remained LESSONS:: Apatinib alone may be a good second-line therapy for advanced HCC patients who are refractory to sorafenib. However, further investigation in future prospective clinical studies is warranted.
RATIONALEHepatocellular carcinoma (HCC) is a highly invasive cancer associated with high mortality rates. Although sorafenib is currently recommended as standard treatment for advanced HCC, its treatment efficacy is limited. Effective treatments for patients with advanced HCC that progresses on or after sorafenib treatment or patients who are intolerant of sorafenib remain an unmet medical need. PATIENT CONCERNSWe report an advanced HCC patient with many lung metastases who failed sorafenib treatment. DIAGNOSESSorafenib refractory HCC patient with a large number of lung metastases. INTERVENTIONSThe apatinib alone was used as second line therapy. OUTCOMESThe patient achieved partial response (PR) soon after the treatment, which was maintained for approximately 1 year. During the entire process, the lung metastases continued to diminish. Finally, only a few lesions remained LESSONS:: Apatinib alone may be a good second-line therapy for advanced HCC patients who are refractory to sorafenib. However, further investigation in future prospective clinical studies is warranted.
Author Zhao, Yaqin
Ma, Xiaojun
Duo, Ji
Zhu, Hong
AuthorAffiliation b Department of Medical Oncology, The People's Hospital of Ganzi Tibetan Autonomous Prefecture, Sichuan, P.R. China
a Department of Medical Oncology, West China Hospital, Sichuan University
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Cites_doi 10.1200/JCO.2015.63.5995
10.18632/oncotarget.20140
10.1200/JCO.2002.07.089
10.1056/NEJMoa0708857
10.1016/S1470-2045(04)01508-6
10.1080/15384047.2017.1323589
10.1200/JCO.2008.20.7753
10.1200/JCO.2013.48.8585
10.1097/MD.0000000000009598
10.18632/oncotarget.14724
10.1016/S1470-2045(08)70285-7
10.1016/S0140-6736(16)32453-9
10.1200/JCO.2012.45.8372
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References Bruix (R4-81-20210404) 2017; 389
Li (R6-81-20210404) 2016; 34
Burroughs (R10-81-20210404) 2004; 5
Liu (R9-81-20210404) 2017; 8
Altekruse (R1-81-20210404) 2009; 27
Llovet (R2-81-20210404) 2008; 359
Li (R5-81-20210404) 2013; 31
Lu (R8-81-20210404) 2017; 18
Poon (R12-81-20210404) 2002; 20
Kou (R13-81-20210404) 2017; 8
Cheng (R3-81-20210404) 2009; 10
Zhu (R7-81-20210404) 2018; 97
Cheng (R11-81-20210404) 2013; 31
References_xml – volume: 34
  start-page: 1448
  year: 2016
  ident: R6-81-20210404
  article-title: Randomized, double-blind, placebo-controlled phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction
  publication-title: J Clin Oncol
  doi: 10.1200/JCO.2015.63.5995
  contributor:
    fullname: Li
– volume: 8
  start-page: 100734
  year: 2017
  ident: R9-81-20210404
  article-title: Efficacy and safety of apatinib combined with transarterial chemoembolization for hepatocellular carcinoma with portal venous tumor thrombus: a retrospective study
  publication-title: Oncotarget
  doi: 10.18632/oncotarget.20140
  contributor:
    fullname: Liu
– volume: 20
  start-page: 1775
  year: 2002
  ident: R12-81-20210404
  article-title: Tumor microvessel density as a predictor of recurrence after resection of hepatocellular carcinoma: a prospective study
  publication-title: J Clin Oncol
  doi: 10.1200/JCO.2002.07.089
  contributor:
    fullname: Poon
– volume: 359
  start-page: 378
  year: 2008
  ident: R2-81-20210404
  article-title: Sorafenib in advanced hepatocellular carcinoma
  publication-title: N Engl J Med
  doi: 10.1056/NEJMoa0708857
  contributor:
    fullname: Llovet
– volume: 5
  start-page: 409
  year: 2004
  ident: R10-81-20210404
  article-title: Systemic treatment and liver transplantation for hepatocellular carcinoma: two ends of the therapeutic spectrum
  publication-title: Lancet Oncol
  doi: 10.1016/S1470-2045(04)01508-6
  contributor:
    fullname: Burroughs
– volume: 18
  start-page: 433
  year: 2017
  ident: R8-81-20210404
  article-title: Comparison of efficacy between TACE combined with apatinib and TACE alone in the treatment of intermediate and advanced hepatocellular carcinoma: a single-center randomized controlled trial
  publication-title: Cancer Biol Ther
  doi: 10.1080/15384047.2017.1323589
  contributor:
    fullname: Lu
– volume: 27
  start-page: 1485
  year: 2009
  ident: R1-81-20210404
  article-title: Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005
  publication-title: J Clin Oncol
  doi: 10.1200/JCO.2008.20.7753
  contributor:
    fullname: Altekruse
– volume: 31
  start-page: 3219
  year: 2013
  ident: R5-81-20210404
  article-title: Apatinib for chemotherapy-refractory advanced metastatic gastric cancer: results from a randomized, placebo-controlled, parallel-arm, phase II trial
  publication-title: J Clin Oncol
  doi: 10.1200/JCO.2013.48.8585
  contributor:
    fullname: Li
– volume: 97
  start-page: e9598
  year: 2018
  ident: R7-81-20210404
  article-title: The radiosensitive effect of apatinib for hepatocellular carcinoma patient with big paraspinal metastasis: a case report
  publication-title: Medicine
  doi: 10.1097/MD.0000000000009598
  contributor:
    fullname: Zhu
– volume: 8
  start-page: 20510
  year: 2017
  ident: R13-81-20210404
  article-title: Significant efficacy and well safety of apatinib in an advanced liver cancer patient: a case report and literature review
  publication-title: Oncotarget
  doi: 10.18632/oncotarget.14724
  contributor:
    fullname: Kou
– volume: 10
  start-page: 25
  year: 2009
  ident: R3-81-20210404
  article-title: Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial
  publication-title: Lancet Oncol
  doi: 10.1016/S1470-2045(08)70285-7
  contributor:
    fullname: Cheng
– volume: 389
  start-page: 56
  year: 2017
  ident: R4-81-20210404
  article-title: Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial
  publication-title: Lancet
  doi: 10.1016/S0140-6736(16)32453-9
  contributor:
    fullname: Bruix
– volume: 31
  start-page: 4067
  year: 2013
  ident: R11-81-20210404
  article-title: Sunitinib versus sorafenib in advanced hepatocellular cancer: results of a randomized phase III trial
  publication-title: J Clin Oncol
  doi: 10.1200/JCO.2012.45.8372
  contributor:
    fullname: Cheng
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Snippet Hepatocellular carcinoma (HCC) is a highly invasive cancer associated with high mortality rates. Although sorafenib is currently recommended as standard...
RATIONALEHepatocellular carcinoma (HCC) is a highly invasive cancer associated with high mortality rates. Although sorafenib is currently recommended as...
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SubjectTerms Adult
Carcinoma, Hepatocellular - diagnostic imaging
Carcinoma, Hepatocellular - drug therapy
Carcinoma, Hepatocellular - pathology
Chemoembolization, Therapeutic - methods
Clinical Case Report
Disease Progression
Fatal Outcome
Humans
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - drug therapy
Liver Neoplasms - pathology
Lung - diagnostic imaging
Lung - microbiology
Lung - pathology
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - pathology
Lung Neoplasms - secondary
Male
Neoplasm Metastasis - drug therapy
Niacinamide - administration & dosage
Niacinamide - analogs & derivatives
Niacinamide - therapeutic use
Phenylurea Compounds - administration & dosage
Phenylurea Compounds - therapeutic use
Protein Kinase Inhibitors - pharmacology
Protein Kinase Inhibitors - therapeutic use
Pyridines - administration & dosage
Pyridines - pharmacology
Pyridines - therapeutic use
Sorafenib
Tomography, X-Ray Computed - methods
Title The excellent antitumor effect of apatinib alone as second-line therapy in a patient with sorafenib-refractory hepatocellular carcinoma: A case report
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