Combined hepatocellular-cholangiocarcinoma successfully treated with sorafenib: case report and review of the literature

Clin J Gastroenterol. 2019 Apr;12(2):128-134. doi: 10.1007/s12328-018-0918-5. Epub 2018 Oct 29.

Abstract

Sorafenib, a multiple kinase inhibitor, has been established as first-line standard systemic chemotherapy for patients with advanced hepatocellular carcinoma (HCC). We encountered a patient with combined hepatocellular and cholangiocarcinoma (CHC) who achieved complete remission in response to sorafenib treatment. A 58-year old man with hepatitis C virus (HCV)-induced liver cirrhosis was diagnosed with CHC in segments 6th and 7th of the liver and underwent partial surgical resection. Three months later, CHC recurred as metastases at multiple intrahepatic sites, lymph nodes, and bones, making surgery impossible. Treatment with sorafenib was initiated at 400 mg b.i.d., later reduced to 400 mg/day. After 6 months of sorafenib administration, he no longer showed abnormal uptake on fluorodeoxyglucose positron emission tomography. He was continued on sorafenib for 2.5 years, but later discontinued due to adverse events. He has shown no evidence of tumor recurrence more than 1 year after sorafenib discontinuation. His HCV was eradicated by direct-acting antivirals, and he remains in good health.

Keywords: Cirrhosis; Combined hepatocellular-cholangiocarcinoma; Hepatitis C virus; Sorafenib; Systemic chemotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Antiviral Agents / therapeutic use
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / secondary
  • Cholangiocarcinoma / drug therapy*
  • Cholangiocarcinoma / secondary
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy
  • Humans
  • Liver Cirrhosis / etiology
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasms, Multiple Primary / drug therapy*
  • Protein Kinase Inhibitors / therapeutic use*
  • Remission Induction
  • Sorafenib / therapeutic use*

Substances

  • Antineoplastic Agents
  • Antiviral Agents
  • Protein Kinase Inhibitors
  • Sorafenib