The role of sorafenib in downsizing hepatocellular carcinoma prior to liver transplantation and in treating tumor recurrence

Abstract

Sorafenib is shown to improve survival in patients with advanced hepatocellular carcinoma(HCC). However, it has as yet not been tested in the liver transplantation (LT) setting. Wereport a 55-year-old man with multifocal HCC (stage B) related to hepatitis B virus cirrhosis(Child-Pugh B), initially treated with transarterial chemoembolization. After five months,sorafenib was added due to lack of response. This enhanced the downsizing of the tumor andeventually led to a surgically successful LT after 4 months of combined treatment. Sorafenibwas re-initiated 15 months post-transplant due to skeletal tumor recurrence and led to patient'sclinical improvement. The patient remains in good clinical condition 3 years after LT.Sorafenib was well tolerated throughout the entire period of administration with no seriousor unexpected adverse events. We conclude that sorafenib can be safely used as a bridge to LTand in transplanted patients in case of HCC recurrence.

Keywords Sorafenib, hepatocellular carcinoma, liver transplantation, transarterial chemoembolization,tumor recurrence

Ann Gastroenterol 2011; 24 (3): 228-230