Radiologic Complete Response with Sirolimus and Sorafenib in a Hepatocellular Carcinoma Patient who Relapsed After Orthotopic Liver Transplantation

Background

No standard therapies have been established for the treatment of recurrent hepatocellular carcinoma (HCC) after liver transplantation.

Discussion

Sirolimus is a mTOR inhibitor which has been used as an immunosuppressive medication in patients who are at high risk of tumor reoccurrence after liver transplantation. Sorafenib is a multikinase inhibitor approved for the treatment of advanced HCC. However the role of sorafenib in patients with HCC reoccurrence after liver transplantation is unclear.

Results

Combination of sirolimus and sorafenib appears to have synergistic effect when treating HCC in preclinical settings. We report a case of a post-liver transplant patient treated with sorafenib and sirolimus for hepatic HCC recurrence who exhibited complete radiologic response after 5 months of therapy.