Complete Response with Immunotherapy Alone after Discontinuing VEGF Inhibitor in Advanced Hepatocellular Carcinoma: A...

Bevacizumab and atezolizumab combination is one of the preferred combinations for managing advanced hepatocellular carcinoma (HCC), while the evidence on monotherapy with either agent is not convincing. We present a case of a man in his 50s diagnosed with HCC with spinal metastases who showed a good response to combination therapy. However, he developed severe proteinuria and hypertension secondary to bevacizumab, which had to be discontinued after 18 cycles. After an informed decision, atezolizumab was continued and the patient showed a sustained response. Till date, he has received 16 additional cycles of atezolizumab monotherapy after discontinuation of bevacizumab and continues to show a persistent response, with a progression-free survival of over 30 months now. It needs to be prospectively evaluated if atezolizumab's effectiveness as monotherapy for extended periods, as in our report, is a residual effect of initial combination therapy or if HCC is intrinsically responsive to immunotherapy alone.

Naviwala MSS, Shoaib D, Khan WA, et al. Complete Response with Immunotherapy Alone after Discontinuing VEGF Inhibitor in Advanced Hepatocellular Carcinoma: A Case Report. Euroasian J Hepato-Gastroenterol 2024;14(2):246-250.