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<p>Cabozantinib, a tyrosine kinase inhibitor that targets not only vascular endothelial growth factor receptors but also hepatocyte growth factor receptor, is characteristically administered as a second or greater line treatment for unresectable hepatocellular carcinoma. Complete remission are extremely rare. We here report a dramatic response to cabozantinib as later-line therapy in a 57-year-old woman with advanced hepatocellular carcinoma. She was found to have multiple recurrences in the remnant liver and bilateral lung metastases 4&#xa0;months after hepatectomy. Retrospective immunohistochemical staining of the resected specimen for hepatocyte growth factor receptor revealed weak positivity. Her disease was judged to be hyper-progressive after 2&#xa0;months of treatment with atezolizumab plus bevacizumab. Second-line treatment with lenvatinib achieved a temporary reduction in alpha-fetoprotein concentration; however, her disease progressed. One week after administering a single dose of durvalumab, 20&#xa0;mg of cabozantinib once daily was initiated. Subsequently, her alpha-fetoprotein concentrations decreased markedly, normalizing at 12&#xa0;weeks, and computed tomography revealed only minor scar-like micronodules in the lungs. She continued cabozantinib, requiring two dose reductions because of adverse effects at 4 and 26&#xa0;weeks. Cabozantinib was discontinued 11&#xa0;months after commencing it. She has now remained drug- and cancer-free for 12&#xa0;months.</p>

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A case of complete remission with durvalumab-cabozantinib sequential therapy for advanced hepatocellular carcinoma

  • 期刊论文

  • 发表日期：

    2026年2月16日

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  • Masaki Ogami,
  • Hironao Okubo,
  • Ryuji Yoshioka,
  • Yuka Fukuo,
  • Kanako Ogura,
  • Yuki Fukumura,
  • Akihiro Mise,
  • Akio Saiura,
  • Kenichi Ikejima,
  • Hiroyuki Isayama

摘要

Cabozantinib, a tyrosine kinase inhibitor that targets not only vascular endothelial growth factor receptors but also hepatocyte growth factor receptor, is characteristically administered as a second or greater line treatment for unresectable hepatocellular carcinoma. Complete remission are extremely rare. We here report a dramatic response to cabozantinib as later-line therapy in a 57-year-old woman with advanced hepatocellular carcinoma. She was found to have multiple recurrences in the remnant liver and bilateral lung metastases 4 months after hepatectomy. Retrospective immunohistochemical staining of the resected specimen for hepatocyte growth factor receptor revealed weak positivity. Her disease was judged to be hyper-progressive after 2 months of treatment with atezolizumab plus bevacizumab. Second-line treatment with lenvatinib achieved a temporary reduction in alpha-fetoprotein concentration; however, her disease progressed. One week after administering a single dose of durvalumab, 20 mg of cabozantinib once daily was initiated. Subsequently, her alpha-fetoprotein concentrations decreased markedly, normalizing at 12 weeks, and computed tomography revealed only minor scar-like micronodules in the lungs. She continued cabozantinib, requiring two dose reductions because of adverse effects at 4 and 26 weeks. Cabozantinib was discontinued 11 months after commencing it. She has now remained drug- and cancer-free for 12 months.