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

Background: 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 have rarely been reported. This case reports a conversion therapy of HAIC combined with Atezolizumab and Bevacizumab for hepatocellular carcinoma. Case description: A 58-year-old male patient, with CT diagnosed as a parenchymal liver mass one week before admission, suggested consideration of hepatocellular carcinoma. Magnetic resonance imaging (MR) 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 at the implanted arterial infusion port in the right groin region. The patient achieved a complete response after four cycles of FOLFOX-HAIC combined Atezolizumab withBevacizumab and then removed the intrahepatic lesion by transformation therapy, with no recurrence at 17 months after surgery, which continued until the submission of this article. Progression-free survival was 21 months. Conclusion: 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 we need to accumulate more experience to better understand its efficacy and potential wider use in the clinical setting.