Long-term complete remission of metastatic combined hepatocellular-cholangiocarcinoma with nivolumab following failure of targeted therapies: a case report

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare and aggressive primary liver malignancy with limited treatment options and poor prognosis. We report the case of 33-year-old male with chronic hepatitis B who underwent hepatectomy and pulmonary metastasectomy for HCC with lung metastases. Histological examination revealed cHCC-CCA. However, new lung and chest wall metastases emerged and sorafenib and regorafenib was administered and failed to control tumor progression. The patient was then treated with nivolumab, which led to a complete remission (CR) after 37 weeks. Remarkably, this response has been sustained for over six years without any immune-related adverse events. This case represents a rare case of long-term CR in metastatic cHCC-CCA following treatment with nivolumab after failure of tyrosine kinase inhibitors, suggesting that nivolumab may represent a promising therapeutic option for this challenging malignancy.