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Bilateral above knee amputations after prolonged exposure to sorafenib and trebananib

Sulsal Haque1, Kyuran Choe1, Olugbenga Olowokure1

  • 1University of Cincinnati, Cincinnati OH, 45267, USA.

Journal of Gastrointestinal Oncology
|December 2, 2014
PubMed

Insights

Sorafenib and trebananib combination therapy showed excellent clinical response in unresectable hepatocellular carcinoma. However, this treatment regimen led to critical limb ischemia requiring amputation.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Sorafenib is an FDA-approved oral tyrosine kinase inhibitor (TKI) targeting multiple pathways implicated in cancer growth.
  • Trebananib is an angiopoietin antagonist designed to inhibit angiogenesis, potentially synergizing with sorafenib.
  • Unresectable hepatocellular carcinoma (HCC) remains a challenging diagnosis with limited treatment options.

Observation:

  • A 66-year-old male with a history of Hepatitis C and smoking presented with unresectable multifocal HCC.
  • The patient received a combination of sorafenib and trebananib for an extended duration.
  • An excellent clinical response to the combined therapy was observed.

Findings:

  • Despite the positive response in HCC, the patient developed bilateral critical limb ischemia.
  • The limb ischemia necessitated bilateral above-knee amputations.

Implications:

  • The combination of sorafenib and trebananib may yield significant clinical benefits in unresectable HCC.
  • Clinicians should be vigilant for potential severe adverse events, such as critical limb ischemia, when using this combination therapy.
  • Further investigation is warranted to understand the risk-benefit profile and optimize the use of sorafenib and trebananib in HCC treatment.
Keywords:
Hepatocellular carcinoma (HCC)anti-angiogenic therapyperipheral vascular disease (PVD)sorafenibtrebananib

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