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Complete response after sorafenib therapy for hepatocellular carcinoma in an HIV-HBV co infected patient: Possible synergy with HAART ? A case report

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Abstract

A significant proportion of HIV patients, ranging between 5–67%, are co-infected with hepatitis B virus (HBV). Several studies suggest an increasing incidence of hepatocellular carcinoma (HCC) in HIV infected individuals. We report the case of a 69 years old male co infected with HBV and HIV who developed HCC. The patient was unfit for curative approach and he underwent three sessions of transcatheter arterial chemoembolisation (TACE). After the last session the disease assessment showed progression and sorafenib therapy was initiated. Highly active antiretroviral therapy (HAART) was continued during sorafenib treatment. The patient achieved a radiological complete response (CR) after 6 months of therapy and remained with no sign of HCC progression at subsequent assessment. Meanwhile, patient’s HIV and HBV infections remained stable. Regarding toxicity the patient developed grade 3 hand foot skin reaction (HFSR) that required 50% dose reduction of sorafenib, grade 3 hypertension and grade 2 diarrhea. In conclusion this is the first case of successful treatment of HCC in a HIV-HBV co-infected patient and only the second report of the co administration of sorafenib with HAART.

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References

  1. Lok AS. Prevention of hepatitis B virus-related hepatocellular carcinoma. Gastroenterology. 2004;127:S303–9.

    Article  PubMed  Google Scholar 

  2. MacDonald DC, Nelson M, Bower M, Powles T, et al. Hepatocellular carcinoma, human immunodeficiency virus and viral hepatitis in the HAART era. World J Gastroenterol. 2008;14(11):1657–63.

    Article  PubMed  Google Scholar 

  3. Iser D, Lewin S. The pathogenesis of liver disease in the setting of HIV-hepatitis B virus coinfection. Antivir Ther. 2009;14(2):155–64.

    PubMed  CAS  Google Scholar 

  4. Bhaskaran K, Hamouda O, Sannes M, et al. Changes in the risk of death after HIV seroconvertion compared with mortality in the general population. JAMA. 2008;300:51–9.

    Article  PubMed  CAS  Google Scholar 

  5. Weber R, Sabin CA, Friis-Moller N, et al. Liver-relared deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med. 2006;166:1632–41.

    Article  PubMed  Google Scholar 

  6. Clifford GM, Rickenbach M, Polesel J, et al. Influence of HIV-related immunodeficiency on the risk of hepatocellular carcinoma. AIDS. 2008;22:2135–41.

    Article  PubMed  CAS  Google Scholar 

  7. Salmon-Ceron D, Rosenthal E, Lewden C, et al. Emerging role of hepatocellular carcinoma among liver-related causes of death in HIV-infected patients The French national Mortalitè 2005 study. J Hepatology. 2009;50:739–45.

    Article  Google Scholar 

  8. Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology. 2005;42:1208–36.

    Article  PubMed  Google Scholar 

  9. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378–90.

    Article  PubMed  CAS  Google Scholar 

  10. Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: A phase III randomized, double-blind, placebo-controlled trial. Lancet Oncol. 2009;10:25–34.

    Article  PubMed  CAS  Google Scholar 

  11. Perboni G, Costa P, Fibbia GC, et al. Sorafenib therapy for Hepatocellular carcinoma in an HIV-HCV Coinfectd Patient: A Case report. The Oncologist. 2010;15(2):142–5. Epub 2010 Feb 8.

    Article  PubMed  CAS  Google Scholar 

  12. So BJ, Bekaii-Saab T, Bloomston MA, Patel T. Complete clinical response of metastatic hepatocellular carcinoma to sorafenib in a patient with hemochromatosis: A case report. Journal of Hematology & Oncology. 2008;1:18.

    Article  Google Scholar 

  13. Chow WA, Jiang C, Guan M. Anti-HIV drugs for cancer therapeutics: back to the future? Lancet Oncol. 2009;10:61–71.

    Article  PubMed  CAS  Google Scholar 

  14. Kumar S, Bryant CS, Chamala S, et al. Ritonavir blocks AKT signalling, activates apoptosis and inhibits migration and invasion in ovarian cancer cells. Mol Cancer. 2009;8:26.

    Article  PubMed  Google Scholar 

  15. Srirangam A, Mitra R, Wang M, et al. Effects of HIV protease inhibitor ritonavir on Akt-regulated cell proliferation in breast cancer. Clin Cancer Res. 2006;12:1883–96.

    Article  PubMed  CAS  Google Scholar 

  16. Villanueva A, Chiang DY, Newell P, et al. Pivotal role of mTOR signalling in hepatocellular carcinoma. Gastroenterology. 2008;135(6):1972–83.

    Article  PubMed  CAS  Google Scholar 

  17. Finn RS. Development of molecularly targeted therapies in hepatocellular carcinoma: where do we go now? Clin Cancer Res. 2010;16(2):390–7. Epub 2010 Jan 12.

    Article  PubMed  CAS  Google Scholar 

  18. Brüning A, Rahmeh M, Gingelmaier A, Friese K. The mitochondria-independent cytotoxic effect of nelfinavir on leukemia cells can be enhanced by sorafenib-mediated mcl-1 downregulation and mitochondrial membrane destabilization. Mol Cancer. 2010;9:19.

    Article  PubMed  Google Scholar 

  19. Brüning A, Burger P, Vogel M, Gingelmaier A, Friese K, Burges A. Nelfinavir induces mitochondria protection by ERK1/2-mediated mcl-1 stabilization that can be overcome by sorafenib. Invest New Drugs;2009.

  20. Soriano V, Vispo E, Labarga P, et al. Viral hepatitis and HIV co-infection. Antiviral Res. 2010;85(1):303–15.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Oncology, Democritus University of Thrace, 68100, Thrace, Alexandroupolis, Dragana, Greece

    Leonidas Chelis, Nikolaos Xenidis, Elen Chamalidou & Stylianos Kakolyris

  2. Second Department of Internal Medicine, Democritus University of Thrace, 68100, Thrace, Alexandroupolis, Dragana, Greece

    Napoleon Ntinos & Eustratios Maltezos

  3. Department of Radiology, Democritus University of Thrace, 68100, Thrace, Alexandroupolis, Dragana, Greece

    Vasilios Souftas & Savas Deftereos

Authors
  1. Leonidas Chelis
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  2. Napoleon Ntinos
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  3. Vasilios Souftas
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  4. Savas Deftereos
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  5. Nikolaos Xenidis
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  6. Elen Chamalidou
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  7. Eustratios Maltezos
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  8. Stylianos Kakolyris
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Correspondence to Leonidas Chelis.

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Chelis, L., Ntinos, N., Souftas, V. et al. Complete response after sorafenib therapy for hepatocellular carcinoma in an HIV-HBV co infected patient: Possible synergy with HAART ? A case report. Med Oncol 28 (Suppl 1), 165–168 (2011). https://doi.org/10.1007/s12032-010-9669-y

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  • DOI: https://doi.org/10.1007/s12032-010-9669-y

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