Aintained DPP-2 Molecular Weight following discontinuation. The present study describes a case of recurrent HCC with a portal vein tumor thrombus (PVTT) of your third portal vein soon after resection within a patient who was treated with sorafenib and accomplished a CR, which was then maintained for a lot more than one year following the discontinuation in the medication. A literature review is also presented. Written informed consent was obtained in the patient. Case report The patient was a 68-year-old male with hepatitis C virus-related liver cirrhosis. A giant HCC was detected and an S7/S8 segmentectomy from the liver was performed at yet another hospital. RORĪ² drug recurrence within the residual liver, PVTT inside the appropriate portal branch and right abdominal disseminated lesions had been noted 4 months immediately after the surgery, despite the fact that only the disseminated lesions have been surgically excised at the request on the patient. The patient was referred to Toho University Health-related Center, Omori Hospital (Tokyo, Japan) to continue remedy for the intrahepatic recurrence. Inside the initial blood tests at the hospital, liver function was graded as Child-Pugh A and tumor marker levels were higher: -fetoprotein (AFP), four,773 ng/Correspondenceto: Dr Manabu Watanabe, Division of Gastroenterology and Hepatology, Division of Internal Medicine, Toho University Health-related Center, Omori Hospital, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541, Japan E-mail: [email protected] Key words: hepatocellular carcinoma, sorafenib, completeresponse, portal vein tumor thrombusSHIOZAWA et al: Complete RESPONSE OF HEPATOCELLULAR CARCINOMA FOLLOWING SORAFENIBml; AFP-L3, 60.five ; and des- carboxyprothrombin (DCP), 17,400 mAU/ml (Fig. 1). Abdominal computed tomography (CT) showed quite a few tumors inside the bilateral lobes and also a PVTT inside the suitable portal branch (Fig. 2). Oral sorafenib therapy was initiated at the advised dose of 800 mg/day. Grade 3 hand-foot syndrome (Frequent Terminology Criteria for Adverse Events version 4.0) (five) created 7 days immediately after the initiation of sorafenib therapy, and the dose was decreased to 400 mg/day on day 10. Just after a single month of administration, the AFP level was decreased to 45.7 ng/ml, but there had been no changes in PVTT or within the many tumors inside the bilateral lobes on abdominal CT. The situation was judged to become of a steady disease according to the modified Response Evaluation Criteria in Strong Tumors (mRECIST) (six). A partial response was achieved immediately after six months. On abdominal CT after two years of sorafenib administration, many tumors in the bilateral lobes had shrunk as well as the intense staining due to the PVTT had been resolved, depending on which the situation was judged to possess achieved a CR. Sorafenib at 400 mg/day was continued thereafter, but mild cerebellar infarction created at two years and four months immediately after the initiation of administration, and sorafenib was withdrawn at the request of the patient. A CR was maintained for approximately 1 year soon after the discontinuation determined by abdominal CT findings and normal tumor marker levels. Discussion Sorafenib is a multikinase inhibitor with reported activity against Raf-1, B-Raf, vascular endothelial growth element receptor two (VEGFR2), platelet-derived growth factor receptor (PDGFR) and c-Kit receptors, at the same time as other receptor tyrosine kinases and serine threonine kinases (7). Sorafenib is usually a molecular-targeted drug that exerts an antitumor effect by inhibiting tumor growth and vascularization. The efficacy of sorafenib has been shown in the SHARP (two) and AsiaPac.
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