Resolution of a hepatoduodenal fistula after nivolumab treatment in a patient with hepatocellular carcinoma: challenges in immunotherapy. Issue 1 (2nd January 2022)

• Record Type: Journal Article
• Authors: De Somer, Thomas; Vanderstraeten, Erik; Bouderez, Vincent; Monsaert, Els; Van Steenkiste, Christophe
• Is Part Of: Acta clinica belgica. Volume 77:Issue 1(2022)
• Page Start: 108
• Page End: 112
• Publication Date: 2022-01-02
• Subjects: Hepatocellular carcinoma -- hepatoduodenal fistula -- nivolumab -- immunotherapy -- oncology; Clinical medicine -- Periodicals; Diagnosis, Laboratory -- Periodicals; 616.005
• DOI: 10.1080/17843286.2020.1778346
• Languages: English
• ISSNs: 1784-3286

Abstract

ABSTRACT: Hepatocellular carcinoma is the fourth leading cause of cancer-related death worldwide, with limited treatment options for patients with advanced hepatocellular carcinoma. Beyond standard systemic therapy with multikinase inhibitors, recent studies demonstrate the potential for a robust and durable response with immune checkpoint inhibition in subsets of patients with hepatocellular carcinoma. We present a case of an 83-year-old male patient with the diagnosis of a multifocal hepatocellular carcinoma. A hepatoduodenal fistula developed under treatment with sorafenib which necessitated treatment interruption. Therefore, a switch to second line therapy with immunotherapy nivolumab was made and supportive enteral nutrition was started. This led to a spectacular oncological response, with complete resolution of the hepatoduodenal fistula. To our knowledge this is the first case which describes the involution of a fistula in a hepatocellular carcinoma under treatment with nivolumab.