Conversion therapy for hepatocellular carcinoma: a case report

Currently, the combination of atezolizumab and bevacizumab is recommended for first-line therapy of advanced hepatocellular carcinoma (HCC). The accumulated world experience of using this treatment modality allows us to state that it significantly improves the overall prognosis of the disease. 
The aim of the study was to evaluate the feasibility of using the combination of atezolizumab + bevacizumab as a conversion therapy for HCC. Case presentation. We report a case of conversion therapy for initially unresectable right-lobe HCC. Due to the insufficient volume of the remaining liver parenchyma (less than 25 %), right-sided hemihepatectomy was considered inappropriate. At the initial stage of treatment, 20 courses of conversion therapy with the atezolizumab + bevacizumab regimen were administered, which was accompanied by a minimum number of adverse events. Subsequently, taking into account the partial response of the tumor to antitumor therapy, radical surgery involving the resection of liver segment s7–8 was performed. Histological examination of the surgical specimen revealed a complete pathological response. 
Conclusion. This case report demonstrates the efficacy of atezolizumab + bevacizumab combination as a conversion therapy for HCC, resulting in complete pathological response. The experience gained emphasizes the need for further research in this area.

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