Initial Strategies in Advanced HCC: Case 2

May 31, 2017

Initial Strategies in Advanced HCC


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