How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life Experience
Background. Hepatocellular carcinoma is a relevant cause of mortality worldwide, mainly among patients who have a prior liver disease. In spite of clear recommendations regarding surveillance and screening methods, most patients are still diagnosed only when they are no longer candidates to curative...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2021/6219896 |
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| author | Gustavo Hideki Kawanami Leopoldo Katsuda Thiara Barcelos Rocha Fabio da Silva Yamashiro Leonardo Pelafsky Xingshun Qi Fernando Gomes Romeiro |
| author_facet | Gustavo Hideki Kawanami Leopoldo Katsuda Thiara Barcelos Rocha Fabio da Silva Yamashiro Leonardo Pelafsky Xingshun Qi Fernando Gomes Romeiro |
| author_sort | Gustavo Hideki Kawanami |
| collection | DOAJ |
| description | Background. Hepatocellular carcinoma is a relevant cause of mortality worldwide, mainly among patients who have a prior liver disease. In spite of clear recommendations regarding surveillance and screening methods, most patients are still diagnosed only when they are no longer candidates to curative treatment modalities, while others do not achieve the goals of such treatments, thus increasing the need of anticancer drugs. Moreover, when cirrhotic patients begin to receive these drugs, many types of adverse events are seen as a reason to withdrawal, even when there are findings suggesting a good response to the treatment. Case Summary. This case report is about a cirrhotic patient who received many types of treatment, from surgery and chemoembolization during early stages to first- and second-line systemic therapy when the disease turned to be advanced. Since he had no signs of liver dysfunction and suffered tumor progression during sorafenib treatment, regorafenib was initiated. The main findings that make this case important are the adverse events after taking this second-line agent, which would certainly be considered unacceptable and would lead to the drug withdrawal. The reasons why regorafenib was maintained are explained based on clinical and imaging findings, showing how this decision led to an excellent response. Conclusions. The knowledge of the main adverse events described in the pilot clinical trials can avoid unnecessary withdrawal of regorafenib. In addition, some clinical and imaging findings can be deemed as predictors of good response to tyrosine kinase inhibitors. |
| format | Article |
| id | doaj-art-b31f1adb73eb402593011c2738e46f45 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-b31f1adb73eb402593011c2738e46f452025-02-03T06:05:35ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972021-01-01202110.1155/2021/62198966219896How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life ExperienceGustavo Hideki Kawanami0Leopoldo Katsuda1Thiara Barcelos Rocha2Fabio da Silva Yamashiro3Leonardo Pelafsky4Xingshun Qi5Fernando Gomes Romeiro6Fundação para o Desenvolvimento Médico e Hospitalar (FAMESP) Hospital Estadual de Bauru, São Paulo, BrazilImagem Diagnósticos Médicos, Bauru, São Paulo, BrazilGastroenterology Division, Department of Internal Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), São Paulo, BrazilFundação para o Desenvolvimento Médico e Hospitalar (FAMESP) Hospital Estadual de Bauru, São Paulo, BrazilSurgery Department, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), São Paulo, BrazilDepartment of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang 110840, ChinaGastroenterology Division, Department of Internal Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), São Paulo, BrazilBackground. Hepatocellular carcinoma is a relevant cause of mortality worldwide, mainly among patients who have a prior liver disease. In spite of clear recommendations regarding surveillance and screening methods, most patients are still diagnosed only when they are no longer candidates to curative treatment modalities, while others do not achieve the goals of such treatments, thus increasing the need of anticancer drugs. Moreover, when cirrhotic patients begin to receive these drugs, many types of adverse events are seen as a reason to withdrawal, even when there are findings suggesting a good response to the treatment. Case Summary. This case report is about a cirrhotic patient who received many types of treatment, from surgery and chemoembolization during early stages to first- and second-line systemic therapy when the disease turned to be advanced. Since he had no signs of liver dysfunction and suffered tumor progression during sorafenib treatment, regorafenib was initiated. The main findings that make this case important are the adverse events after taking this second-line agent, which would certainly be considered unacceptable and would lead to the drug withdrawal. The reasons why regorafenib was maintained are explained based on clinical and imaging findings, showing how this decision led to an excellent response. Conclusions. The knowledge of the main adverse events described in the pilot clinical trials can avoid unnecessary withdrawal of regorafenib. In addition, some clinical and imaging findings can be deemed as predictors of good response to tyrosine kinase inhibitors.http://dx.doi.org/10.1155/2021/6219896 |
| spellingShingle | Gustavo Hideki Kawanami Leopoldo Katsuda Thiara Barcelos Rocha Fabio da Silva Yamashiro Leonardo Pelafsky Xingshun Qi Fernando Gomes Romeiro How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life Experience Canadian Journal of Gastroenterology and Hepatology |
| title | How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life Experience |
| title_full | How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life Experience |
| title_fullStr | How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life Experience |
| title_full_unstemmed | How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life Experience |
| title_short | How Much Time Should Be Waited and What Are the Main Findings to Evaluate the Hepatocellular Carcinoma Response to Regorafenib? A Real-Life Experience |
| title_sort | how much time should be waited and what are the main findings to evaluate the hepatocellular carcinoma response to regorafenib a real life experience |
| url | http://dx.doi.org/10.1155/2021/6219896 |
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