ONCAlert | 2018 ASCO Annual Meeting
Hepatocellular Carcinoma Case Studies

Case Studies: Later Line Therapeutic Decisions in Metastatic HCC

In this case-based interview series, Anthony El-Khoueiry, MD, outlines the most important factors to consider in advanced hepatocellular carcinoma and discusses treatment options in patients who have progressed following therapy with sorafenib.

Later Line Therapeutic Decisions in Metastatic HCC

February 2014

  • A 63-year old male with HBV
  • ECOG=0
  • Child-Pugh A; platelet count 230,000 cells/mcL
  • Bilirubin 1.0 mg/dL; Albumin 3.5 g/dL
  • CT scan revealed liver lesions, 1 is 2-cm; 1 is 5-cm both in the right lobe
  • No extrahepatic disease
  • Biopsy confirmed HCC diagnosis
  • AFP=5400 IU/ml
  • Tumors were resected with RO margin

August 2016

  • Imaging showed recurrence in the liver, metastatic disease in the lungs
  • Therapy was initiated with sorafenib 400 mg BID
  • Therapy was well-tolerated

April 2017

  • Radiographic progression with multiple lung metastases
  • ECOG=0
  • Therapy with regorafenib initiated at 160 mg
  • Starting dose was well-tolerated, patient experienced some fatigue
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