Clinical experience of regorafenib combined with camrelizumab in the treatment of refractory recurrent liver cancer with complete remission_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Jingzhu ¹ , LI Haoquan ¹ ,  WANG Zaiguo ¹ , YE Zhenwei ¹ , CHEN Yunhao ¹ , ZHANG Weibiao ² , LIAO Jingsheng ³

1. Department of Hepatobiliary and Pancreatic Surgery, Dongguan Hospital Affiliated to Southern Medical University, Dongguan, Guangdong 523059, P. R. China;
2. Nuclear Medicine Department, Dongguan Hospital Affiliated to Southern Medical University, Dongguan, Guangdong 523059, P. R. China;
3. Internal Medicine of Digestive Oncology, Dongguan Hospital Affiliated to Southern Medical University, Dongguan, Guangdong 523059, P. R. China;

Corresponding?author：

WANG Zaiguo, Email: wangzaiguo@sina.com

Keywords：

hepatocellular carcinoma; recurrent cancer; treatment; regorafenib; camrelizumab

DOI：

10.7507/1007-9424.202207040

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore a new method for the treatment of refractory recurrent liver cancer. Methods The treatment process and effect of a patient with refractory recurrent liver cancer who received complete remission (CR) treated with second-line targeted drug regorafenib combined with camrelizumab in the Department of Hepatobiliary and Pancreatic Surgery of Dongguan Hospital Affiliated to Southern Medical University were retrospectively analyzed and summarized. Results In the previous 3 years, the patient underwent radical ablation, resection of recurrent cancer in the middle lobe of the liver, ablation of recurrent cancer in S2 and S8 segments of the liver, and multidisciplinary treatment with the first-line targeted drug lenvatinib, extensive intrahepatic recurrence and metastasis still occurred. Finally, the patient was treated with the second-line targeted drug regorafenib combined with camrelizumab for systemic treatment. All the intrahepatic lesions were liquefied and necrotic, and most of them were significantly reduced or disappeared, AFP decreased from the highest peak of 20 867.00 μg/L to normal. The therapeutic effect of CR was evaluated and remained stable for more than 12 months. There were no obvious toxic and side effects. The patient had a good quality of life and insisted on working normally. Conclusion The second-line targeted drug regorafenib combined with new immunotherapy may still have curative effect on refractory recurrent liver cancer after various comprehensive treatment failures, and even obtain the hope and opportunity of long-term tumor-free survival.

Citation： JIANG Jingzhu, LI Haoquan, WANG Zaiguo, YE Zhenwei, CHEN Yunhao, ZHANG Weibiao, LIAO Jingsheng. Clinical experience of regorafenib combined with camrelizumab in the treatment of refractory recurrent liver cancer with complete remission. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(9): 1149-1153. doi: 10.7507/1007-9424.202207040 Copy

1.	丁福全, 王在國. 肝癌復發轉移的臨床研究進展. 中國實用外科雜志, 2000, 20(3): 174-175.
2.	Nakayama H, Takayama T. Role of surgical resection for hepatocellular carcinoma based on Japanese clinical guidelines for hepatocellular carcinoma. World J Hepatol, 2015, 7(2): 261-269.
3.	中華人民共和國國家衛生和計劃生育委員會. 原發性肝癌診療規范(2017年版). 臨床肝膽病雜志, 2017, 33(8): 1419-1431.
4.	陳延宇, 張曉赟, 李川, 等. 復發性肝細胞癌的外科治療現狀與進展. 華西醫學, 2019, 34(6): 688-692.
5.	林鵬, 蔡敏清, 房俊偉, 等. 肝癌術后復發的外科治療研究現狀及進展. 器官移植, 2022, 13(1): 111-119.
6.	Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol, 2022, 76(3): 681-693.
7.	Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
8.	國家科技部傳染病防治重大專項課題《病毒性肝炎相關肝癌外科綜合治療的個體化和新策略研究》專家組. 肝細胞癌肝切除術后復發預防和治療中國專家共識(2020版). 中國實用外科雜志, 2021, 41(1): 20-30.
9.	Erridge S, Pucher PH, Markar SR, et al. Meta-analysis of determinants of survival following treatment of recurrent hepatocellular carcinoma. Br J Surg, 2017, 104(11): 1433-1442.
10.	中國抗癌協會肝癌專業委員會, 中國抗癌協會臨床腫瘤學協作專業委員會, 中華醫學會肝病學分會肝癌學組. 原發性肝癌局部消融治療的專家共識. 臨床腫瘤學雜志, 2011, 16(1): 70-73.
11.	Zhang W, Zhang B, Chen XP. Adjuvant treatment strategy after curative resection for hepatocellular carcinoma. Front Med, 2021, 15(2): 155-169.
12.	蔣經柱, 李浩權, 王在國, 等. 免疫聯合靶向方案治療晚期肝癌臨床研究. 中國腫瘤外科雜志, 2022, 14(2): 120-126.
13.	Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet, 2018, 391(10126): 1163-1173.
14.	Lim H, Ramjeesingh R, Liu D, et al. Optimizing survival and the changing landscape of targeted therapy for intermediate and advanced hepatocellular carcinoma: A systematic review. J Natl Cancer Inst, 2021, 113(2): 123-136.
15.	Zhu AX, Finn RS, Edeline J, et al. Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): a non-randomised, open-label phase 2 trial. Lancet Oncol, 2018, 19(7): 940-952.
16.	Jiang Y, Sun A, Zhao Y, et al. Proteomics identifies new therapeutic targets of early-stage hepatocellular carcinoma. Nature, 2019, 567(7747): 257-261.
17.	Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med, 2008, 359(4): 378-390.
18.	Cheng AL, Kang YK, Chen Z, et al. 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. Lancet Oncol, 2009, 10(1): 25-34.
19.	Facciorusso A, Abd El Aziz MA, Sacco R. Efficacy of regorafenib in hepatocellular carcinoma patients: A systematic review and meta-analysis. Cancers (Basel), 2019, 12(1): 36. doi: 10.3390/cancers12010036.
20.	Bruix J, Qin S, Merle P, et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet, 2017, 389(10064): 56-66.

1. 丁福全, 王在國. 肝癌復發轉移的臨床研究進展. 中國實用外科雜志, 2000, 20(3): 174-175.
2. Nakayama H, Takayama T. Role of surgical resection for hepatocellular carcinoma based on Japanese clinical guidelines for hepatocellular carcinoma. World J Hepatol, 2015, 7(2): 261-269.
3. 中華人民共和國國家衛生和計劃生育委員會. 原發性肝癌診療規范(2017年版). 臨床肝膽病雜志, 2017, 33(8): 1419-1431.
4. 陳延宇, 張曉赟, 李川, 等. 復發性肝細胞癌的外科治療現狀與進展. 華西醫學, 2019, 34(6): 688-692.
5. 林鵬, 蔡敏清, 房俊偉, 等. 肝癌術后復發的外科治療研究現狀及進展. 器官移植, 2022, 13(1): 111-119.
6. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol, 2022, 76(3): 681-693.
7. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
8. 國家科技部傳染病防治重大專項課題《病毒性肝炎相關肝癌外科綜合治療的個體化和新策略研究》專家組. 肝細胞癌肝切除術后復發預防和治療中國專家共識(2020版). 中國實用外科雜志, 2021, 41(1): 20-30.
9. Erridge S, Pucher PH, Markar SR, et al. Meta-analysis of determinants of survival following treatment of recurrent hepatocellular carcinoma. Br J Surg, 2017, 104(11): 1433-1442.
10. 中國抗癌協會肝癌專業委員會, 中國抗癌協會臨床腫瘤學協作專業委員會, 中華醫學會肝病學分會肝癌學組. 原發性肝癌局部消融治療的專家共識. 臨床腫瘤學雜志, 2011, 16(1): 70-73.
11. Zhang W, Zhang B, Chen XP. Adjuvant treatment strategy after curative resection for hepatocellular carcinoma. Front Med, 2021, 15(2): 155-169.
12. 蔣經柱, 李浩權, 王在國, 等. 免疫聯合靶向方案治療晚期肝癌臨床研究. 中國腫瘤外科雜志, 2022, 14(2): 120-126.
13. Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet, 2018, 391(10126): 1163-1173.
14. Lim H, Ramjeesingh R, Liu D, et al. Optimizing survival and the changing landscape of targeted therapy for intermediate and advanced hepatocellular carcinoma: A systematic review. J Natl Cancer Inst, 2021, 113(2): 123-136.
15. Zhu AX, Finn RS, Edeline J, et al. Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): a non-randomised, open-label phase 2 trial. Lancet Oncol, 2018, 19(7): 940-952.
16. Jiang Y, Sun A, Zhao Y, et al. Proteomics identifies new therapeutic targets of early-stage hepatocellular carcinoma. Nature, 2019, 567(7747): 257-261.
17. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med, 2008, 359(4): 378-390.
18. Cheng AL, Kang YK, Chen Z, et al. 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. Lancet Oncol, 2009, 10(1): 25-34.
19. Facciorusso A, Abd El Aziz MA, Sacco R. Efficacy of regorafenib in hepatocellular carcinoma patients: A systematic review and meta-analysis. Cancers (Basel), 2019, 12(1): 36. doi: 10.3390/cancers12010036.
20. Bruix J, Qin S, Merle P, et al. Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet, 2017, 389(10064): 56-66.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical experience of regorafenib combined with camrelizumab in the treatment of refractory recurrent liver cancer with complete remission

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content