A case of recurrent HCC successfully treated with lenvatinib

Abstract

Abstract We herein report a case of HCC who got CR treated with lenvatinib. A 70-year old man had chronic hepatitis C and got a virologic response by PegIFN+Riv in 201X-4. He drunk liquor 5 go a day. He underwent hepatic left lobe resection for the Hepatocellular carcinoma, moderately differentiated, vp2, vv0,va0, b3, single-engine, 3.2cm, the Background liver A1/F2, as a diagnosis of stageIII for HCC in Dec 201X-1. In April 201X, CT and MRI showed recurrent HCC occupied great part of the residual liver (portal vein embolus vp3 (P7)). Blood test results showed elevation of AST 70U/l, ALT 90U/l, G-GTP 255U/l, T-Bil 0.9mg/dl, AFP 245ng/ml, PIVKA-II 843mAU/ml. His performance status (PS) was 0, and, he received lemvatinib monotherapy (8mg/day) in May. Early adverse events were hoarse voice, hand-foot syndrome and hypertension, all Grade 1. He used anti-hypertensive agent, steroid cream. In Oct, Anorexia appeared, so lenvatinib were reduced to 4mg so that anorexia improved, his BP normalized without agent and his hoarse voice disappeared. Tumor marker became normalized in Sep. CT scan showed good PR in Jun, Aug, and Oct gradually. In Dec CT scan showed elimination of early enhancement of HCC, although remaining P7 stenosis. We diagnosed CR and that is now continuing in 201X+1. We experienced a rare case of rapid HCC growth obtained CR treated with lenvatinib.