Abstract
Hepatocellular carcinoma (HCC) is a common malignant tumor with high extent of invasiveness. Its invasion process is closely related to complex tumor microenvironment and microvascular characteristics. Recently, immune combined targeted therapy has been applied to patients, combination therapy program with better effect needs to be explored. Atezolizumab combined Bevacizumab regimen in phase III clinical trial IMbrave150 was approved by U.S. Federal Drug Administration (FDA) for HCC treatment. This program is mostly used for liver malignant tumors have failed other treatments. Patients in terminal stage, overall curative has an unsatisfactory effect, survival time of patients is limited. Therefore, seeking best plan for combined treatment to improve patient's life quality and survival rate are still one of the most important clinical difficulties. This report describes a 37-year-old male who suffered from HCC repeatedly relapsed after hepatectomy. The patient received transcatheter arterial chemoembolization (TACE), microwave ablation (MWA), targeted therapy, and other combined treatments, all showed poor treatment effects. He received liver transplantation (LT) after receiving PD-1 blockade combined targeted therapy, eventually died due to severe immune rejection. It's first case of an allogeneic liver transplantation patient who received PD-1 blockade and Lenvaxen combined therapy. PD-1 blockade treatment and clinical observations of this case were summarized.
Highlights
Liver cancer has become the second largest tumor in China
Tumors can suppress immune response of the immune system by activating negative regulatory pathways related to immune homeostasis
immune checkpoints inhibitors (ICIs) interfere with immunosuppressive signals to maintain immune homeostasis and enhance the body’s antitumor immunity
Summary
Liver cancer has become the second largest tumor in China. Most liver cancers develop from chronic hepatitis B. Display according to timeline: HCC patient with history of hepatitis B for more than 20 years received partial liver resection in 2018 After operation, he was complicated by repeated intrahepatic tumor recurrence and metastasis. He was complicated by repeated intrahepatic tumor recurrence and metastasis He received various combined treatments such as liver resection, tumor chemotherapy, transcatheter arterial chemoembolization (TACE), liver MWA therapy, and single-dose Lenvaxen targeted therapy, but the effect was limited. When targeted drugs and PD-1 blockade were used, AFP level decreased significantly and remained within normal range, and CD4 cell and CD8 cell counts continued to increase slowly This result showed combination therapy had obvious benefits to the patient.
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