ONCAlert | 2018 ASCO Annual Meeting
Hepatocellular Carcinoma Case Studies

Case Studies: Initial Strategies in Advanced HCC

In this case-based interview series, Richard S. Finn, MD, illustrates how various comorbidities impact the management of advanced hepatocellular carcinoma and discusses initial treatment options, including liver transplantation, locoregional therapy, and systemic therapy.

Initial Strategies in Advanced HCC: Case 2

June 2015

  • A 62-year old female smoker with a history of alcoholism and type 2 diabetes, HTN is experiencing fatigue
  • ECOG=1
  • Child-Pugh A
  • T bilirubin 1.4; albumin 3.8; INR 1.1; no ascites, no encephalopathy; platelets 94
  • CT scan reveals one 6-cm liver mass with invasion into the right branch of the portal vein, metastatic disease involving the abdominal lymph nodes and lung
  • Biopsy confirmed HCC diagnosis; poorly differentiated
  • Patient admitted nonadherence to anti-hypertensive medications
  • Therapy was initiated with sorafenib at 400 mg BID
  • Patient experienced grade 1 HTN, fatigue, dyspepsia, grade 3 diarrhea
  • Dose was reduced to 400 mg QD, antimotility agents were given
  • Patient was counselled regarding diet

July 2016

  • Follow-up imaging has shown stable disease
  • ECOG=1
  • Patient is now Child-Pugh B
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