title: Complete radiographic remission with 5-fluorouracil and leucovorin after sorafenib failure in hepatocellular carcinoma: is there a role for chemotherapy after targeted agents?
abstract: A 57-year-old Caucasian man with a history of Child's class A hepatitis C, cirrhosis and progressive multifocal hepatocellular carcinoma was treated with sorafenib but progressed after 7 months of stable disease. At progression he was given salvage chemotherapy consisting of 5-fluorouracil and leucovorin and went into complete radiographic remission after 12 cycles of treatment. He did develop a portal vein thrombosis but nevertheless his hepatic lesions continued to resolve. Throughout his therapy α-fetoprotein (AFP) levels decreased only minimally. He did not seek retreatment after 14 cycles of chemotherapy and presented 3 months later with relapsed disease on CT scans with markedly elevated AFP levels. He received one more chemotherapy cycle but was unable to tolerate further treatment, succumbing to his disease 3 months thereafter, and a total of 29 months after he was deemed a sorafenib failure.
authors.affiliation: Section of Hematology Oncology, Veteran Affairs Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Tan-Shalaby
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017809:Fatal Outcome; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000188:drug therapy*; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use; D000077157:Sorafenib; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D014803:Vitamin B Complex; D009536:Niacinamide; D000077157:Sorafenib; D002955:Leucovorin; D005472:Fluorouracil
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