Naviwala Mohammad Ss, Shoaib Daania, Khan Waqas A, Zaki Adeeba
Department of Medical Oncology, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
Euroasian J Hepatogastroenterol. 2024 Jul-Dec;14(2):246-250. doi: 10.5005/jp-journals-10018-1455. Epub 2024 Dec 27.
Bevacizumab and atezolizumab combination is one of the preferred combinations for managing advanced hepatocellular carcinoma (HCC), while the evidence on monotherapy with either agent is not convincing. We present a case of a man in his 50s diagnosed with HCC with spinal metastases who showed a good response to combination therapy. However, he developed severe proteinuria and hypertension secondary to bevacizumab, which had to be discontinued after 18 cycles. After an informed decision, atezolizumab was continued and the patient showed a sustained response. Till date, he has received 16 additional cycles of atezolizumab monotherapy after discontinuation of bevacizumab and continues to show a persistent response, with a progression-free survival of over 30 months now. It needs to be prospectively evaluated if atezolizumab's effectiveness as monotherapy for extended periods, as in our report, is a residual effect of initial combination therapy or if HCC is intrinsically responsive to immunotherapy alone.
Naviwala MSS, Shoaib D, Khan WA, Complete Response with Immunotherapy Alone after Discontinuing VEGF Inhibitor in Advanced Hepatocellular Carcinoma: A Case Report. Euroasian J Hepato-Gastroenterol 2024;14(2):246-250.
贝伐单抗和阿替利珠单抗联合用药是治疗晚期肝细胞癌（HCC）的首选联合方案之一，而单用这两种药物之一进行治疗的证据并不令人信服。我们报告了一例50多岁的男性患者，诊断为HCC伴脊柱转移，对联合治疗反应良好。然而，他因贝伐单抗出现了严重的蛋白尿和高血压，在18个周期后不得不停药。在做出明智的决定后，继续使用阿替利珠单抗，患者显示出持续的反应。迄今为止，在停用贝伐单抗后，他又接受了16个周期的阿替利珠单抗单药治疗，持续显示出持久反应，无进展生存期现已超过30个月。像我们报告中这样，阿替利珠单抗长期单药治疗的有效性是初始联合治疗的残留效应，还是HCC本身对免疫治疗有反应，这需要进行前瞻性评估。
Naviwala MSS, Shoaib D, Khan WA, 晚期肝细胞癌停用血管内皮生长因子抑制剂后单纯免疫治疗获得完全缓解：一例报告。《欧亚肝脏胃肠病学杂志》2024；14(2):246 - 250。
