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