The role of sorafenib in downsizing hepatocellular carcinoma prior to liver transplantation and in treating tumor recurrence.
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. We report 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 and eventually led to a surgically successful LT after 4 months of combined treatment. Sorafenib was re-initiated 15 months post-transplant due to skeletal tumor recurrence and led to patient's clinical improvement. The patient remains in good clinical condition 3 years after LT. Sorafenib was well tolerated throughout the entire period of administration with no serious or unexpected adverse events. We conclude that sorafenib can be safely used as a bridge to LT and in transplanted patients in case of HCC recurrence.
Aristotle University of Thessaloniki, Thessaloniki, Greece (Emmanouil Sinakos, Lavrentis Papalavrentios, Evangelos Akriviadis).
Emmanouil
E
Sinakos
Miami Transplant Institute, University of Miami, Miller School of Medicine, Miami, USA (Gennaro Selvaggi, Andreas Tzakis).
Gennaro
G
Selvaggi
Aristotle University of Thessaloniki, Thessaloniki, Greece (Emmanouil Sinakos, Lavrentis Papalavrentios, Evangelos Akriviadis).
Lavrentis
L
Papalavrentios
Miami Transplant Institute, University of Miami, Miller School of Medicine, Miami, USA (Gennaro Selvaggi, Andreas Tzakis).
Andreas
A
Tzakis
Aristotle University of Thessaloniki, Thessaloniki, Greece (Emmanouil Sinakos, Lavrentis Papalavrentios, Evangelos Akriviadis).
Evangelos
E
Akriviadis
Sorafenib; hepatocellular carcinoma; liver transplantation; transarterial chemoembolization; tumor recurrence