Anthony El-Khoueiry, MD

69-Year-Old Man With Stage IV Hepatocellular Carcinoma

Patient Prognosis and Risk Factors in HCC and Cirrhosis

IMbrave150 Trial: Combination Therapy in Advanced HCC

Second-Line Therapy in Advanced HCC

Additional Second- and Third-Line Treatment Options in HCC

Future Treatment Landscape of Advanced HCC

Case: A 69-Year-Old Man with Stage 4 Hepatocellular Carcinoma

A 69-year-old man presented with vague right upper quadrant abdominal discomfort, decreased appetite and occasional nausea and vomiting

PMH: diabetes, medially controlled; hepatitis B virus diagnosed and treated 8 years ago

SH: moderate amount of alcohol use (2-3 drinks a day)

Labs: AFP 425 ng/mL, bilirubin 1.2 mg/dL, AST 102 U/L, ALT 116 U/L, ALP 380 U/L, INR 1.6, albumin 3.6 g/dL, BUN 15 mg/dL, creatinine 1.5 mg/dL, plt 205,000

Abdominal ultrasound revealed 2 hepatic lesions

Chest/abdominal/pelvic CT scan confirmed 2 lesions in the right hepatic lobe measuring 3.2 cm and 5.5 cm, a suspicious lesion in the left lung lobe, and wide-spread lymphadenopathy noted

Biopsy findings showed grade 3 HCC with marked fibrosis

Surgical consult: unresectable due to tumor size and location

Treatment with atezolizumab + bevacizumab was initiated

First imaging shows stable disease at 2 months; imaging at 4-month follow-up showed 2 new lung lesions

Treatment was subsequently changed to cabozantinib 60 mg PO qDay

Videos

Anthony El-Khoueiry, MD, provides insight on the case of a 69-year-old man with stage 4 hepatocellular carcinoma and evaluates current and emerging treatment options.

Anthony El-Khoueiry, MD | Authors

Articles

A 69-Year-Old Man With Stage 4 Hepatocellular Carcinoma