Journal of Clinical Case Reports

ISSN: 2165-7920

Open Access

A Case of Hepatocellular Carcinoma with a Complete Response to Second-Line Chemotherapy with Ramucirumab


Makoto Ueno*, Satoshi Kobayashi, Yusuke Sano, Taito Fukushima, Hiroyuki Asama, Satoshi Tanaka, Shuhei Nagashima, Kuniyuki Kawano and Manabu Morimoto

Introduction: Ramucirumab has become the standard of care in second-line systemic therapy for advanced Hepatocellular Carcinoma (HCC) (AFP ≥400 ng/ml). A Complete Response (CR) to systemic therapy is generally very rare. We encountered a patient who achieved CR to secondline therapy with ramucirumab.

Case presentation: We herein report a case of a 62-year-old male diagnosed with HCC and lung metastases 6 months after liver surgery. AFP and PIVKA-II were elevated and his liver function was Child-Pugh A. Sorafenib at 800 mg as the first-line therapy was administered for 6 weeks, and after the progression of the first-line therapy ramucirumab was administered as second-line systemic therapy. The tumor decreased in size and this was judged to be a partial response. Due to the absence of recurrence for approximately 5 years after the cessation of treatment, the present case was considered to have achieved CR.

Conclusion: We encountered a case of HCC with CR to second-line systemic therapy with ramucirumab after sorafenib. The high affinity of ramucirumab to vascular endothelial growth factor receptor 2 (VEGFR2) may have exerted additional anti-tumor effects in cases refractory to systemic therapy having anti-VEGF effects.


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