A case of hepatocellular carcinoma obtained marked anti-tumor effect by low dose sorafenib after the progression of the disease during high-dose of sorafenib

Abstract

A 79-year-old woman with hepatocellular carcinomas (HCCs) were treated by transcatheter arterial chemoembolization (TACE). But she was considered as TACE-refractory because of increasing tumors. Her liver function was Child-Pugh grade A and she was treated with sorafenib at an initial dose of 800 mg/day. Seven days after the initiation, the dose was reduced to 400 mg/day because of hand-foot syndrome. Computed tomography (CT) after 2 months demonstrated progression of HCCs, and therapeutic effect (TE) was considered as progressive disease (PD) by Response Evaluation Criteria in Solid Tumors (RESIST). The dose was further reduced to 200 mg/day because of re-appearance of hand-foot syndrome after 2.5 months. She had continued sorafenib treatment, and after 4 months CT showed marked reduction of HCCs, and tumor markers were also decreased. Sorafenib treatment is continued with the dose of 200 mg/day, and the TE has been maintained partial remission (PR) for 9 months.