B.S. Kashakov¹, M.S. Akbarova¹

1. «Kyzylorda Regional Oncology Center» MSE on REM, Kyzylorda, the Republic of Kazakhstan

DOI: https://www.doi.org/10.52532/2521-6414-2023-4-70-28-30

UDC: 616.36-006:085.615.28

Year: 2023 issure: 70 number: 4 pages: 28-30

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ABSTRACT

Relevance: Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. HCC is one of the most important problems of the oncology service of Kazakhstan, as it has a progressive course, late detection, low survival, and unfavorable prognosis.
The study aimed to evaluate the use of targeted immunotherapy in treating hepatocellular carcinoma in a clinical example.
Methods: The paper presents a clinical case of targeted immunotherapy in combination with Atezolizumab 1200 mg + Bevacizumab 800 mg, once every 3 weeks, in treating HCC in the Regional Oncology Center in Kyzylorda.
Results: The first symptoms of liver damage appeared in 2018, at which time HCC was discovered. Viral hepatitis B was diagnosed in 2016. MRI OBP from 15.08.20: a picture of the right lobe of the liver in S5 – 9×7×6 cm, in S3 – 3.7 cm, in S7 – 3.0 cm, in S8 – 2.5 cm. During the follow-up examination (July 2021), the enzyme immunoassay revealed a high angiotensin-converting enzyme (ACE) level of 450.56 IU/ml; the abdominal CT scan showed no deterioration. Later, despite the therapy, ACE increased rapidly: 2,595.3 IU/ml (August 2021) and 2,142.25 IU/ml (September 2021), and the therapy was changed to Regorafenib. ACE continued to rise to 4,405 IU/ml (November 2021) and 18,005 IU/ml (December 2021). A control abdominal CT scan showed a moderate reduction in the size of the tumor.
Taking into account a steady ACE increase, in February 2022, the patient was recommended therapy with Atezolizumab and Bevacizumab. In January 2023, the patient has already received 13 courses, and ACE continued to decrease: 1,932 IU/ml (January 2023), 53.38 IU/ml (February 2023), 16.07 IU/ml (March 2023), and the abdominal CT scan showed positive dynamics.
Conclusion: Targeted immunotherapy showed its effectiveness in the described case of inoperable HCC and allowed the patient to continue living, working, and leading an active lifestyle for more than 18 months.
Keywords: liver, hepatocellular carcinoma (HCC), targeted immunotherapy, clinical case.

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