HCC, Portal Vein and Opdivo

Wayne C

I want to give you a brief history of my treatment. I have had a combined treatment of Y90 Radioembolization with Nivolumab. All my doctors say I am not in the textbooks or in uncharted territory. They really don't know what to offer me. My goal is first tell you my results and success and ask your knowledge and assistance in what you think of my treatment and what my future treatment should be. Let me think you first for your time and knowledge. 

 

I am a 66 years old male,  with no history of cirrhosis, smoking or hepatitis. But, June 2017 I was diagnosed with advanced HCC with PVTT.  The tumor is in the right lobe and was 12.8 cm x 10.2 cm with portal vein tumor involvement and my initial AFP was 2500.  In July, I had Therasphere with Y90. My AFP was 18,000 on September 1 and 25,000 on October 15.

 

I was started on Sorafenib and took for 1 month which made me very sick. Started Nivolumab Nov. 8. 

After 8 Nivolumab 240mg treatments, CT was done on Feb. 27, 2018. CT showed shrinkage of the tumor to 4.8cm x 6.0cm. My AFP was 3.2. A month later the AFP is 2.1. There is still portal vein involvement. Initially, there was some question about metastasis to right lung and L4. This has been evaluated by several radiologists and latest there is no metastasis. 

 

Currently, I am feeling very good. Liver function is normal. I am now looking at the next step. I am continuing the Nivolumab 240 mg every other week. My doctors really don't have an answer. They are considering Y90 again even though my initial response was poor. There has been some consideration of resection. But, they say there is no bridge to that treatment at present. They are also concerned about the toxicity of Y90. I decided not to do the Y90 again.

 

I saw my oncologist on Thursday and had my 14th treatment with Opdivo (Nivolumab). He says continue Opdivo until there are problems. I  am wondering what the end game is. I am not a surgery candidate. Did you have portal vein issues? 

 

Anyone else have any comments on portal vein treatment, TASE, or additional treatment? ThanksH

 

jbrody

Hi Wayne,

Hi Wayne,

I wanted to check in here and see how you were doing... hopefully well. I'm curious what your side effects were after Y-90 and how long it took you to feel well.