NEXAVA failing lung mets symptomatic: what next?

dais

anyone having success with clinical trials?

Female, Asian, 65, primary HCC diagnosed Nov 2011

1) greyish white liver mass, 7.5x6 cm, adjacent to capsular, with 10+ satelite lesions, ranging 0.2 - 0.8 cm in diameter.  

2) also seen greyish white mass 5x5x4 cm with membrane, section face grey to brown in color, partially hemorragic.  Alongside gastric tissue measuring 4x2x1 cm. Suspected GIST

Diagnosis: right-side hepatocellular carcinoma, grade II - III with 2ndary lesions, sorrounding hepatic tissue G1S0; spleen and stomach interstitial stromal tumor suspected. 

 

Treatment history

Nov 18, 2011 - surgery.  Section VI, VII, VIII and partial diaphram resected, stomach partly removed due to GIST 

Nov 18, 2011 - TACE: EADM and Lipiodol 

Feb 7, 2012 - TACE.  Mets to both lungs.  Starting sorafenib, 800mg + 800mg per day

Jun 15, 2012 - TACE.  Stopped sorafenib

Aur 9, 2012 - TACE + BAI

Aug 16, 2012 - resuming sorafenib 800 mg + 400 mg per day

 

Laboratory

AFP 60500

CEA 2.17

CA19-9 9.4

AST 66

AP 84

GGT 174

Bile acid 52.0

bilirubin - slightly elevated, 22.4 total/ 7.4 conjugated

kidney function - normal, creatinine 45,micromol/L, eGFR 121