RESUMEN
Hepatocellular carcinoma (HCC) is a common and highly malignant tumor with poor outcomes, especially when it metastasizes. In this report, we present the case of a 64-year-old male patient diagnosed with recurrence and multiple metastases of HCC 7 years after surgery. As the tumor invaded the spinal canal and pressed on the spinal cord, the patient experienced paralysis in the lower limbs. After undergoing surgical resection for spinal decompression, the patient chose an innovative regimen: QL1604 200 mg every 3 weeks plus bevacizumab 675 mg every 3 weeks as first-line treatment. From July 2022 to February 2024, the patient has regularly received the treatment. During the treatment, the paralysis symptoms of the patient gradually improved, and the motor function of the lower limbs completely returned to normal. When re-evaluated his spinal cord injury, the Frankel grade of the patient was downgraded from C to E. The tumor shrank to reach a state of PR and lasted for one and a half years. QL1604 combined with bevacizumab demonstrated excellent efficacy and minimal side effects in this patient. This new combined therapy holds potential as a first-line treatment strategy.
RESUMEN
Temozolomide (TMZ) has been used as a first-line therapy against lower-grade gliomas (LGGs) combined with other chemotherapy drugs. However, there has been no reliable index predicting TMZ response of patients with LGGs. In this study, we aim to investigate the relationship between gene expressions and the prognosis of TMZ therapy in LGGs. We integrated transcriptome and clinical data of 171 LGGs from the Chinese Glioma Genome Atlas (CGGA). Consensus LASSO Cox regression was used to identify 14 key genes related to different clinical outcomes under TMZ chemotherapy. We constructed and evaluated a risk score based on the 14 genes. Patients with LGGs of lower risk scores (low-risk group) generally had better survival than those LGGs of higher risk scores (high-risk group), which is independent of clinicopathological factors. High-risk patients showed activation of innate and humoral-type immunity. The prognostic contribution of the risk score was validated in an independent validation cohort of 65 patients. Besides, combined with three independent predictors (grade, IDH1 mutation status, and chr1p19q co-deletion status), we further developed a nomogram to predict the benefit of TMZ treatment in LGGs. Our results indicate that a transcriptome-based index can optimize the treatment strategy for patients with LGGs under TMZ therapy.
RESUMEN
Hepatocellular carcinoma (HCC) is a tumor with a high degree of malignancy. Patients have poor outcomes and short survival times, especially after progression to first-line systemic therapy. Regorafenib is the standard second-line treatment for HCC, but there is no conclusive evidence that regorafenib combined with immunotherapy can be used as a second-line treatment. We present the case of a 50-year-old man with a chronic hepatitis B (CHB) infection for more than 30 years who was diagnosed with stage Barcelona Clinic Liver Cancer (BCLC)-B hepatocellular carcinoma. Unfortunately, recurrence and metastasis occurred soon after radical surgery and standard first-line treatment with lenvatinib. The patient was then treated with regorafenib plus sintilimab as second-line treatment. Surprisingly, soon after treatment, the patient reached a state of partial response (PR) that lasted for more than one year, which is currently close to that of complete response (CR). Regorafenib combined with sintilimab as second-line treatment showed an excellent curative effect in this patient, who had HCC with multiple metastases to the liver and lungs. This treatment, which has tolerable side effects, enabled the patient to reach a state of PR that lasted over one year, which is currently close to CR. Therefore, it may be a potential second-line treatment strategy.