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已发表论文
病例报告：肝动脉灌注化疗联合卡度尼利单抗与多纳非尼治疗后Vp4型门静脉癌栓肝细胞癌的成功手术切除
Authors Chen S, Wei Y , Liao X, Yang C, Zhu G , Han C, Su H, Peng T
Received 20 July 2025
Accepted for publication 19 November 2025
Published 6 December 2025 Volume 2025:18 Pages 279—286
DOI https://doi.org/10.2147/PGPM.S555061
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Martin H Bluth
Sizhi Chen,1 Yongguang Wei,1,2 Xiwen Liao,1,2 Chengkun Yang,1,2 Guangzhi Zhu,1,2 Chuangye Han,1,2 Hao Su,1,2 Tao Peng1– 3
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China; 2Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, 530021, People’s Republic of China; 3Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, People’s Republic of China
Correspondence: Hao Su, Email tntboy1982@163.com Tao Peng, Email pengtaogmu@163.com
Objective: To evaluate the potential and efficacy of hepatic artery infusion chemotherapy combined with the PD-1/CTLA-4 bispecific antibody cadonilimab and the multi-kinase inhibitor donafenib in conversion therapy for unresectable hepatocellular carcinoma (uHCC) with Vp4-type portal vein tumor thrombus(PVTT).
Methods: We present a case report of a 41-year-old male diagnosed with diffuse hepatocellular carcinoma (HCC) in the right lobe of the liver and tumor thrombus involving the main portal vein. Following multidisciplinary team evaluation, the patient received conversion therapy consisting of hepatic artery infusion chemotherapy (HAIC) using oxaliplatin, fluorouracil, and leucovorin, in combination with cadonilimab and donafenib.
Results: Post-treatment imaging demonstrated marked regression of intrahepatic tumors and complete resolution of the portal vein tumor thrombus. Serum alpha-fetoprotein (AFP) levels normalized, and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels showed a significant decline. Subsequently, a radical right hepatectomy was successfully performed, and postoperative pathological examination confirmed complete response. The patient experienced an uneventful recovery and remained free of tumor recurrence during the one-year follow-up period.
Conclusion: The integrative treatment strategy combining HAIC with cadonilimab and donafenib demonstrates considerable promise as a conversion approach for patients with traditionally unresectable HCC with Vp4-type PVTT. This regimen may substantially improve oncological outcomes and enable curative resection. This case provides compelling evidence to support further clinical investigation of this multimodal therapeutic combination.
Keywords: hepatocellular carcinoma, conversion therapy, interventional therapy, bispecific antibodies, portal vein tumor thrombus, case report
1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China; 2Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, 530021, People’s Republic of China; 3Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, People’s Republic of China
Correspondence: Hao Su, Email tntboy1982@163.com Tao Peng, Email pengtaogmu@163.com
Objective: To evaluate the potential and efficacy of hepatic artery infusion chemotherapy combined with the PD-1/CTLA-4 bispecific antibody cadonilimab and the multi-kinase inhibitor donafenib in conversion therapy for unresectable hepatocellular carcinoma (uHCC) with Vp4-type portal vein tumor thrombus(PVTT).
Methods: We present a case report of a 41-year-old male diagnosed with diffuse hepatocellular carcinoma (HCC) in the right lobe of the liver and tumor thrombus involving the main portal vein. Following multidisciplinary team evaluation, the patient received conversion therapy consisting of hepatic artery infusion chemotherapy (HAIC) using oxaliplatin, fluorouracil, and leucovorin, in combination with cadonilimab and donafenib.
Results: Post-treatment imaging demonstrated marked regression of intrahepatic tumors and complete resolution of the portal vein tumor thrombus. Serum alpha-fetoprotein (AFP) levels normalized, and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels showed a significant decline. Subsequently, a radical right hepatectomy was successfully performed, and postoperative pathological examination confirmed complete response. The patient experienced an uneventful recovery and remained free of tumor recurrence during the one-year follow-up period.
Conclusion: The integrative treatment strategy combining HAIC with cadonilimab and donafenib demonstrates considerable promise as a conversion approach for patients with traditionally unresectable HCC with Vp4-type PVTT. This regimen may substantially improve oncological outcomes and enable curative resection. This case provides compelling evidence to support further clinical investigation of this multimodal therapeutic combination.
Keywords: hepatocellular carcinoma, conversion therapy, interventional therapy, bispecific antibodies, portal vein tumor thrombus, case report