title: Late-onset benefit in progressive advanced hepatocellular carcinoma with continued sorafenib therapy: a case report.
abstract: BACKGROUND
  In the past, no effective systemic therapy has existed for patients with advanced hepatocellular carcinoma. Sorafenib, an oral multikinase inhibitor, has recently been shown to improve overall survival in patients with advanced hepatocellular carcinoma in two randomized, double-blinded, placebo-controlled trials. This drug has been approved as the first-line therapy for advanced hepatocellular carcinoma patients. We report an intriguing case of advanced hepatocellular carcinoma in which the patient achieved late- onset partial response by prolonged administration of sorafenib in spite of progressive disease.
  
  
  METHODS
  A 54-year-old Japanese man was treated with sorafenib for multiple lung metastases after surgical resection for advanced hepatocellular carcinoma accompanied by vascular invasion of the left branch of the portal vein. Although the effective diagnosis was progressive disease, almost all sites began to reduce or disappear eight months after the diagnosis of progressive disease. A dramatic reduction in alpha-fetoprotein and des-gamma-carboxy prothrombin levels was observed. The patient finally achieved partial response and his status remains unchanged.
  
  
  CONCLUSIONS
  If tolerated, prolonged sorafenib treatment may be beneficial.
authors.affiliation: Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, Sagamihara, Kanagawa 252-0380, Japan. okuyu@kitasato-u.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okuwaki
authors.forename: Takahide
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Hidaka
authors.forename: Akitaka
authors.initials: A
authors.lastname: Shibuya
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi