A Successful Case of Hepatocellular Carcinoma Treated with Atezolizumab Plus Bevacizumab with Multisystem Immune-related Adverse Events

A 63-year-old man with hepatitis C was treated with atezolizumab plus bevacizumab for unresectable diffuse hepatocellular carcinoma (HCC). After four cycles of atezolizumab plus bevacizumab, the diffuse HCC markedly shrank; however, he complained of general fatigue, loss of appetite, and slight loss...

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Bibliographic Details
Published in:Internal Medicine 2022/12/01, Vol.61(23), pp.3497-3502
Main Authors: Hayashi, Hidemi, Sawada, Koji, Hasebe, Takumu, Nakajima, Shunsuke, Sawada, Jun, Takiyama, Yuri, Takiyama, Yumi, Okumura, Toshikatsu, Fujiya, Mikihiro
Format: Article
Language:English
Subjects:
Adrenocorticotropic hormone
Adverse events
Appetite loss
atezolizumab
Bevacizumab
Bevacizumab - adverse effects
Carcinoma, Hepatocellular - drug therapy
Case Report
Hepatitis C
Hepatocellular carcinoma
Humans
Hydrocortisone
Hypothyroidism
Immune checkpoint
Internal medicine
isolated adrenocorticotropic hormone deficiency
Liver Neoplasms - drug therapy
Male
Middle Aged
multisystem immune-related adverse effects
Muscle strength
Myopathy
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Summary:A 63-year-old man with hepatitis C was treated with atezolizumab plus bevacizumab for unresectable diffuse hepatocellular carcinoma (HCC). After four cycles of atezolizumab plus bevacizumab, the diffuse HCC markedly shrank; however, he complained of general fatigue, loss of appetite, and slight loss of muscle strength in the lower legs. He was diagnosed with isolated adrenocorticotropic hormone deficiency (IAD), hypothyroidism, and myopathy, suggesting multisystem immune-related adverse events (irAEs). After administration of hydrocortisone, the clinical symptoms rapidly disappeared. Patients with multisystem irAEs can have favorable outcomes; thus, to continue immune-checkpoint inhibitors therapy, a correct diagnosis and management of multisystem irAEs are important.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9393-22