Complete Response of Hepatocellular Carcinoma with Macroscopic Vascular Invasion and Pulmonary Metastasis to the Combination of Drug-Eluting Beads Transarterial Chemoembolization and Huaier Granule: A Case Report

Tan-Yang Zhou; Guo-Fang Tao; Sheng-Qun Chen; Hong-Liang Wang; Yue-Lin Zhang; Guan-Hui Zhou; Chun-Hui Nie; Tong-Yin Zhu; Bao-Quan Wang; Zi-Niu Yu; Li Jing; Feng Chen; Jun-Hui Sun

doi:10.2147/OTT.S309660

Complete Response of Hepatocellular Carcinoma with Macroscopic Vascular Invasion and Pulmonary Metastasis to the Combination of Drug-Eluting Beads Transarterial Chemoembolization and Huaier Granule: A Case Report

Onco Targets Ther. 2021 Jun 23:14:3873-3880. doi: 10.2147/OTT.S309660. eCollection 2021.

Authors

Tan-Yang Zhou^{1

2}, Guo-Fang Tao³, Sheng-Qun Chen^{1

2}, Hong-Liang Wang^{1

2}, Yue-Lin Zhang^{1

2}, Guan-Hui Zhou^{1

2}, Chun-Hui Nie^{1

2}, Tong-Yin Zhu^{1

2}, Bao-Quan Wang^{1

2}, Zi-Niu Yu^{1

2}, Li Jing^{1

2}, Feng Chen⁴, Jun-Hui Sun^{1

2

5}

Affiliations

¹ Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, People's Republic of China.
² Zhejiang Provincial Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou, 310003, Zhejiang Province, People's Republic of China.
³ Department of Respiratory Medicine, Thoracic Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, People's Republic of China.
⁴ Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
⁵ Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou, 310003, Zhejiang Province, People's Republic of China.

Abstract

Background: Hepatocellular carcinoma (HCC) associated with macroscopic vascular invasion and distant metastasis is an advanced-stage disease with an extremely poor prognosis and low survival rate. Therefore, there is an urgent need to develop novel therapeutic strategies to extend the lives of patients with advanced HCC.

Case presentation: We represent a case of HCC with macroscopic vascular invasion and pulmonary metastasis responding dramatically to the combination treatment with drug-eluting beads transarterial chemoembolization (DEB-TACE) and Huaier granule. A 64-year-old man with hepatitis B virus (HBV)-induced liver cirrhosis was diagnosed with advanced HCC involved renal vein and inferior vena cava accompanied by pulmonary metastasis. The patient received three cycles of on-demand DEB-TACE from 9th September 2016 to 22nd August 2017 and combined with Huaier granule 20 g three times a day orally. Eight months following the treatment, complete response occurred with regression of HCC and vascular thrombus and disappearance of pulmonary metastasis. The levels of AFP had decreased from 8165.8ng/mL to within the normal range (1.7 ng/mL). This is the first case report of complete response of HCC to the combination treatment with DEB-TACE and Huaier granule. At the most recent follow-up, he remained in remission 36 months after cessation of treatment without clinical or imaging evidence of disease recurrence. The current overall survival is 54 months since the initial treatment.

Conclusion: Data from this clinical case report suggest that the combination treatment with DEB-TACE and Huaier granule is a promising therapeutic option for advanced HCC with macroscopic vascular invasion and distant metastasis.

Keywords: Huaier; drug-eluting beads; hepatocellular carcinoma; traditional Chinese medicine; vascular invasion.

Publication types

Case Reports

Grants and funding

This work was sponsored by Zhejiang Provincial Natural Science Foundation of China (Grant No.LZ18H180001), National Natural Science Foundation of China (Grant No. 81971713), National S&T Major Project of China (NO.2018ZX10301201), Grant from the Health Commission of Zhejiang Province (JBZX-202004), Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences(2019RU019) and Research Fund for Interventional Oncology of China Health Promotion Foundation(No.XM_2018_011_0006_01).