Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Division of Medical Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan.
BMC Gastroenterol. 2021 Dec 15;21(1):470. doi: 10.1186/s12876-021-02053-4.
Hepatocellular carcinoma (HCC) with major portal vein tumor thrombus (Vp4 PVTT) is an extremely advanced tumor with limited treatment options. Systemic chemotherapy is the only recommended treatment option, and atezolizumab plus bevacizumab has recently emerged as a first-line treatment option.
We describe the case of an 82-year-old man with unresectable advanced HCC with Vp4 PVTT who achieved a significant response to atezolizumab plus bevacizumab treatment. A single administration of atezolizumab plus bevacizumab ensured significant anti-tumor effects (regression in the tumor size and PVTT, portal vein recanalization, and serum alfa-fetoprotein levels decreased from 90,770 to 89 ng/mL). The patient continued with atezolizumab monotherapy, and after nine consecutive regimens, there was no apparent sign of residual tumor.
This case demonstrates the powerful anti-tumor effect of atezolizumab plus bevacizumab treatment for advanced HCC with Vp4 PVTT, suggesting that these agents can be a promising treatment option for such refractory tumors.
伴有主门静脉癌栓（Vp4 PVTT）的肝细胞癌（HCC）是一种极为晚期的肿瘤，治疗选择有限。系统化疗是唯一推荐的治疗选择，阿替利珠单抗联合贝伐珠单抗最近已成为一线治疗选择。
我们描述了一例 82 岁不可切除的晚期 HCC 伴 Vp4 PVTT 患者，其对阿替利珠单抗联合贝伐珠单抗治疗有显著反应。单次给予阿替利珠单抗联合贝伐珠单抗可确保显著的抗肿瘤效果（肿瘤大小和 PVTT 缩小，门静脉再通，血清甲胎蛋白水平从 90770 降至 89ng/ml）。患者继续接受阿替利珠单抗单药治疗，连续九个疗程后，未见明显残留肿瘤迹象。
该病例表明阿替利珠单抗联合贝伐珠单抗治疗伴有 Vp4 PVTT 的晚期 HCC 具有强大的抗肿瘤作用，提示这些药物可能是此类难治性肿瘤的一种有前途的治疗选择。
