Sequential therapy of transarterial chemoembolisation and sorafenib in intermediate stage hepatocellular carcinoma

Prolongation of median survival can be achieved for intermediate Barcelona Clinic Liver Cancer stage hepatocellular carcinoma (HCC) by transarterial chemoembolisation (TACE). TACE might induce induction of angiogenic factors, especially in patients not responding to TACE, which might result in further tumour progression with development of new satellite lesions.

Here, we report a patient with intermediate stage HCC, who initially responded to TACE, but developed new satellite lesions. After careful discussion, TACE was stopped, and a sequential treatment with sorafenib, a vascular endothelial growth factor receptor and RAF tyrosinkinase inhibitor, was started, resulting in a progression-free survival of 10 months.

The presented case demonstrates the feasibility of sequential TACE and sorafenib treatment. Results of ongoing controlled, clinical trials in this regard are awaited.