scholarly journals Spontaneous Regression of Advanced Hepatocellular Carcinoma

2020 ◽  
Vol 14 (3) ◽  
pp. 491-496
Author(s):  
Dhiraj J. Sonbare ◽  
Rupal Bandi ◽  
Vivek Sharma ◽  
Thomas Cacciarelli ◽  
Obaid S. Shaikh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Invasion ◽  
Spontaneous Regression ◽  
Tumor Regression ◽  
Complete Regression ◽  
Advanced Hepatocellular Carcinoma ◽  
Specific Therapy ◽  
Therapeutic Implications ◽  
Spontaneous Tumor Regression ◽  
Related Mortality

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. The tumor carries poor prognosis with curative therapeutic options limited to surgical resection, tumor ablation, and liver transplantation. Rarely, there is spontaneous regression of the tumor. We describe the case of a 74-year-old male with cirrhosis from non-alcoholic steatohepatitis who developed advanced HCC that was associated with tumor invasion of the portal vein and marked elevation of serum alfa-fetoprotein level. The patient received no cancer-specific therapy. However, 1 year after the initial diagnosis, he was noted to have complete regression of the tumor. In this report, we discuss possible mechanisms of spontaneous tumor regression and its therapeutic implications.

Regression of Hepatocellular Carcinoma Spontaneous or Herbal Medicine Related?

2004 ◽  
Vol 32 (04) ◽  
pp. 579-585 ◽  
Author(s):  
Hon Mei Cheng ◽  
Ming Che Tsai
Keyword(s):  
Hepatocellular Carcinoma ◽  
Herbal Medicine ◽  
Spontaneous Regression ◽  
Causes Of Death ◽  
Arterial Embolization ◽  
Complete Regression ◽  
Advanced Hepatocellular Carcinoma ◽  
Traditional Herbal Medicine ◽  
Common Causes

Hepatocellular carcinoma is one of the most common causes of death from cancer in Taiwan. Treatments for this disease include surgical resection, transcatheter arterial embolization, chemoembolization and systemic chemotherapy. Without treatment, the prognosis of hepatocellular carcinoma is poor, and mortality continues to be significant even in patients with small tumors detected during follow-up. For patients in Taiwan with advanced hepatocellular carcinoma, traditional herbal medicine is frequently used. However, neither the overall prevalence of this therapy nor its efficacy has been studied systematically. Spontaneous regression of cancer, although rare, may occur, but the mechanism leading to regression is still far from understood. Here, we report a case of hepatocellular carcinoma with complete regression after taking herbal medicine. We cannot be certain how significant the herbal preparation was in the regression of the hepatocellular carcinoma, but the regression of the tumor provides us a reason and hope for further research.

One- year mortality in patients with advanced hepatocellular carcinoma on immunotherapy: Prediction using machine learning models (Preprint)

2021 ◽  
Author(s):  
Thomas Ka-Luen Lui ◽  
Ka Shing, Michael Cheung ◽  
Wai Keung Leung
Keyword(s):  
Machine Learning ◽  
Hepatocellular Carcinoma ◽  
Characteristic Curve ◽  
False Negative ◽  
False Negative Rate ◽  
Absolute Error ◽  
Advanced Hepatocellular Carcinoma ◽  
Data Set ◽  
One Year ◽  
Related Mortality

BACKGROUND Immunotherapy is a new promising treatment for patients with advanced hepatocellular carcinoma (HCC), but is costly and potentially associated with considerable side effects. OBJECTIVE This study aimed to evaluate the role of machine learning (ML) models in predicting the one-year cancer-related mortality in advanced HCC patients treated with immunotherapy METHODS 395 HCC patients who had received immunotherapy (including nivolumab, pembrolizumab or ipilimumab) in 2014 - 2019 in Hong Kong were included. The whole data set were randomly divided into training (n=316) and validation (n=79) set. The data set, including 45 clinical variables, was used to construct six different ML models in predicting the risk of one-year mortality. The performances of ML models were measured by the area under receiver operating characteristic curve (AUC) and the mean absolute error (MAE) using calibration analysis. RESULTS The overall one-year cancer-related mortality was 51.1%. Of the six ML models, the random forest (RF) has the highest AUC of 0.93 (95%CI: 0.86-0.98), which was better than logistic regression (0.82, p=0.01) and XGBoost (0.86, p=0.04). RF also had the lowest false positive (6.7%) and false negative rate (2.8%). High baseline AFP, bilirubin and alkaline phosphatase were three common risk factors identified by all ML models. CONCLUSIONS ML models could predict one-year cancer-related mortality of HCC patients treated with immunotherapy, which may help to select patients who would most benefit from this new treatment option.

Complete regression of locally advanced hepatocellular carcinoma induced by sorafenib allowing curative resection

2011 ◽  
Vol 31 (5) ◽  
pp. 740-743 ◽  
Author(s):  
Sabine Irtan ◽  
Xavier Chopin-Laly ◽  
Maxime Ronot ◽  
Sandrine Faivre ◽  
Valérie Paradis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Curative Resection ◽  
Locally Advanced ◽  
Complete Regression ◽  
Advanced Hepatocellular Carcinoma

scholarly journals Spontaneous Regression of Metastatic Papillary Thyroid Cancer in a Lymph Node

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Jien Shim ◽  
Jianyu Rao ◽  
Run Yu
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Spontaneous Regression ◽  
Cervical Lymph Node Metastasis ◽  
Additional Treatment ◽  
Complete Regression ◽  
Papillary Thyroid ◽  
Specific Therapy ◽  
Structural Disease

Spontaneous regression of cancer is defined as disappearance of cancer in the absence of specific therapy. In thyroid cancer patients with biochemically incomplete response to initial treatments, spontaneous decline in thyroglobulin levels without any cancer treatment is a well-known phenomenon; however, spontaneous regression of persistent or recurrent structural disease has not been reported. We here present a case of papillary thyroid cancer in a 58-year-old female who underwent total thyroidectomy and two radioiodine ablations. She had persistently elevated thyroglobulin levels. Six years after her initial treatments, she had biopsy-proven cervical lymph node metastasis. The patient opted not to undergo any further treatment. Over the course of the next 10 years, without any additional treatment, the lymph node disappeared and her thyroglobulin levels decreased to almost undetectable ranges, implying near-complete regression. Our case illustrates that metastatic papillary thyroid cancer in lymph nodes can regress spontaneously.

Activity of cabozantinib (XL184) in hepatocellular carcinoma: Results from a phase II randomized discontinuation trial (RDT).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4007-4007 ◽  
Author(s):  
Chris Verslype ◽  
Allen Lee Cohn ◽  
Robin Katie Kelley ◽  
Tsai-Shen Yang ◽  
Wu-Chou Su ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Primary Endpoint ◽  
Tumor Regression ◽  
Progression Free Survival ◽  
Median Number ◽  
Advanced Hepatocellular Carcinoma ◽  
Open Label ◽  
Sorafenib Treatment ◽  
Systemic Treatments ◽  
Hep B

4007 Background: Cabozantinib (cabo) is an oral, potent inhibitor of MET and VEGFR2. MET over-expression has been observed in advanced hepatocellular carcinoma (HCC). Anti-VEGF pathway agents have shown clinical benefit in pts w/ HCC. Simultaneous targeting of the MET and VEGF signaling pathways with cabo may therefore be a promising treatment strategy. Methods: Eligible HCC patients (pts) were required to have measurable disease per RECIST, ≤ 1 prior systemic regimen and Child-Pugh score of A. Pts received cabo at 100 mg qd over a 12 wk Lead-in stage. Tumor response (mRECIST) was assessed q6 wks. Treatment ≥ wk 12 was based on response: pts with PR continued open-label cabo, pts with SD were randomized to cabo vs placebo, and pts with PD discontinued. Primary endpoint in the randomized phase was progression free survival (PFS). The primary endpoint was overall response rate (RR) per mRECIST in the Lead-in stage. Results: Enrollment has been completed (n = 41); all pts are unblinded. Median age: 61 years (33 to 83). Males: 76%; Asian: 37%. HCC etiology: Hep B 24%; Hep C 22%; alcohol abuse 20%; other 38%. Extra-hepatic spread observed in 70%. Median number of prior systemic treatments was 1; prior sorafenib was 51%. Median baseline AFP was 368 ng/mL (3 – 259,298); 86% had elevated AFP at baseline. Median follow-up was 5.5 mos (0.8 -18.5). 29 pts (71%) completed the Lead-in stage. Median PFS from Study Day 1 was 4.2 mos. 2/36 pts evaluable for tumor assessment at 12 weeks achieved a confirmed PR (cPR) by original RECIST (RR 5%). One more pt randomized at Week 12 achieved a cPR at 18 weeks. 28/36 pts (78%) with ≥1 post-baseline scan had tumor regression (with no apparent relationship to prior sorafenib therapy). The overall disease control rate (DCR = PR+SD) at Week 12: was 68% (Asian subgroup: 73%). AFP responses (defined as reduction from baseline of >50% in pts with elevated AFP at baseline) in 26 pts with ≥1 post-baseline result: 10/26 (38%). Most common Gr 3/4 AEs: diarrhea (17%), palmar-plantar erythrodyesthesia (15%), and thrombocytopenia (10%). Conclusions: Cabo treatment exhibits activity in HCC pts regardless of prior sorafenib treatment. The safety profile was comparable to that of other VEGFR TKIs.

Combination therapy with lenvatinib and anti-PD-1 antibodies for unresectable or advanced hepatocellular carcinoma: A real-world study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16610-e16610
Author(s):  
Hui-Chuan Sun ◽  
Xiao-Dong Zhu ◽  
Cheng Huang ◽  
Ying-Hao Shen ◽  
Ning-Ling Ge ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Combination Therapy ◽  
Adverse Events ◽  
Combination Treatment ◽  
Tumor Regression ◽  
R0 Resection ◽  
Advanced Hepatocellular Carcinoma ◽  
First Line ◽  
Angiogenic Therapy ◽  
First Line Therapy

e16610 Background: Combination therapy of anti-angiogenic therapy and anti-PD-1 antibody had shown promising anti-tumor effects for advanced hepatocellular carcinoma (HCC) in clinical trials. Here we report the effectiveness and safety of the combination therapy of lenvatinib and anti-PD-1 antibodies in a cohort of unresectable or advanced HCC pts. Methods: From Sep 2018 to Jan 2020, 77 consecutive pts received a combination treatment of lenvatinib and an anti-PD-1 antibody. Lenvatinib was given 8 mg/d regardless of patient body weight and anti-PD-1 antibody was used either q2wk (nivolumab or camrelizumab) or q3wk (pembrolizumab, sintilimab or toripalimab). pts who completed at least one efficacy and safety assessment were eligible for this study. Tumor response were evaluated with abdominal contrast-enhanced MRI/CT and/or chest CT every 2 mo (± 1 wk). Laboratory tests were monitored every 2-3 wk. Results: 59 pts were eligible for this study. Of them, 1 (1.7%) were BCLC stage A, 10 (16.9%) were BCLC stage B, 48 (81.4%) were BCLC stage C (including 20 pts in China Liver Cancer [CNLC] stage IIIa and 28 in CNLC stage IIIb). 43 (72.9%) pts were treated as first-line therapy. The table below shows efficacy results. R0 resection was performed in 6 (10.2%) pts due to tumor regression. By the data cut-off date, 13 pts died, and mOS was not mature. Overall, the combination treatment was well tolerated. 28 (47.5%) pts had at least one ≥ grade 3 treatment-emergent adverse event. 3 (5.1%) pts died from immune-related adverse events, 2 of them died from immune-related adverse events after hepatectomy. Conclusions: The combination of lenvatinib + anti-PD-1 antibody is effective and well-tolerated in pts with HCC as first-line or second-line treatment. It is also noted that initially unresectable HCC may be converted to resectable HCC following this combination treatment. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document