Hepatic arterial infusion chemotherapy via arterial infusion port combined with Atezolizumab and Bevacizumab for conversion therapy of advanced hepatocellular carcinoma: a case report

The effectiveness of combination therapies with multiple mechanisms of action in treating advanced hepatocellular carcinoma (HCC) has been highlighted by the observed synergistic antitumor effects. The conversion therapy of hepatic arterial infusion chemotherapy (HAIC) with Atezolizumab and Bevacizumab in HCC has rarely been reported. This case reports a conversion therapy of HAIC combined with Atezolizumab and Bevacizumab for hepatocellular carcinoma. A 58-year-old male patient, with CT diagnosed as a parenchymal liver mass 1 week before admission, suggesting consideration of hepatocellular carcinoma. Further magnetic resonance imaging (MRI) of the liver in our hospital revealed a huge tumor in the right lobe of the liver with large vascular invasion, suggesting a malignant lesion. We performed the HAIC via the implanted arterial infusion port catheter in the right groin region. The patient achieved a complete response after four cycles of FOLFOX-HAIC combined with Atezolizumab and Bevacizumab and then underwent surgical resection of the intrahepatic lesion following conversion therapy, with no recurrence at 17 months after surgery, and this status has continued until the submission of this article. Progression-free survival was 21 months. The combined approach of FOLFOX-HAIC via transarterial infusion port with Atezolizumab and Bevacizumab showed promising results with the potential to improve treatment compliance in certain patients while providing the opportunity for radical surgical resection of advanced HCC. Given these encouraging results, further research on this combination treatment regimen is necessary, and accumulation of further experience is needed to better understand its efficacy and potential wider use in the clinical setting.