Marked Response to Nivolumab Plus Ipilimumab After the Failure of Two Prior Immune Checkpoint Inhibitor–Based Regimens Including CTLA-4 Blockade in Advanced Hepatocellular Carcinoma
Abstract
Immune checkpoint inhibitor (ICI)-based combination therapies are standard treatments for advanced hepatocellular carcinoma (HCC). However, the efficacy of sequential ICI regimens remains unclear. We report the case of a 59-year-old woman with advanced HCC with peritoneal dissemination who showed rapid tumor regression after nivolumab plus ipilimumab as a third ICI-based regimen, following confirmed progression on durvalumab plus tremelimumab and atezolizumab plus bevacizumab. After two cycles, tumor markers markedly decreased, and radiological evaluation demonstrated a partial response by Response Evaluation Criteria in Solid Tumors (RECIST) and a complete response by modified RECIST (mRECIST). By late May 20XX+2, the patient had completed four cycles of nivolumab plus ipilimumab without any additional adverse events. The marked biochemical response was maintained, with alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II levels further decreasing to 173.6 ng/mL and 76 mAU/mL, respectively. The patient is currently scheduled for a follow-up radiological evaluation to confirm the durability of the response. This case suggests that nivolumab combined with ipilimumab may retain efficacy even after multiple prior ICI failures.
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BibTeX
@article{minami2026marked,
title = {{Marked Response to Nivolumab Plus Ipilimumab After the Failure of Two Prior Immune Checkpoint Inhibitor–Based Regimens Including CTLA-4 Blockade in Advanced Hepatocellular Carcinoma}},
author = {Shinichiro Minami and Wataru Sato and Kenjiro Yamamoto and Mitsuru Chiba and Kenichi Takahashi and Mari Matsuyama and Ryo Kikuchi and Yuma Sato and Hiroki Koshiishi and Katsunori Iijima},
journal = {Internal Medicine},
year = {2026},
month = jul,
doi = {10.2169/internalmedicine.7779-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7779-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Marked Response to Nivolumab Plus Ipilimumab After the Failure of Two Prior Immune Checkpoint Inhibitor–Based Regimens Including CTLA-4 Blockade in Advanced Hepatocellular Carcinoma
AU - Shinichiro Minami
AU - Wataru Sato
AU - Kenjiro Yamamoto
AU - Mitsuru Chiba
AU - Kenichi Takahashi
AU - Mari Matsuyama
AU - Ryo Kikuchi
AU - Yuma Sato
AU - Hiroki Koshiishi
AU - Katsunori Iijima
PY - 2026
DA - 2026/07/18
JO - Internal Medicine
DO - 10.2169/internalmedicine.7779-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7779-26/_article
AB - Immune checkpoint inhibitor (ICI)-based combination therapies are standard treatments for advanced hepatocellular carcinoma (HCC). However, the efficacy of sequential ICI regimens remains unclear. We report the case of a 59-year-old woman with advanced HCC with peritoneal dissemination who showed rapid tumor regression after nivolumab plus ipilimumab as a third ICI-based regimen, following confirmed progression on durvalumab plus tremelimumab and atezolizumab plus bevacizumab. After two cycles, tumor markers markedly decreased, and radiological evaluation demonstrated a partial response by Response Evaluation Criteria in Solid Tumors (RECIST) and a complete response by modified RECIST (mRECIST). By late May 20XX+2, the patient had completed four cycles of nivolumab plus ipilimumab without any additional adverse events. The marked biochemical response was maintained, with alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II levels further decreasing to 173.6 ng/mL and 76 mAU/mL, respectively. The patient is currently scheduled for a follow-up radiological evaluation to confirm the durability of the response. This case suggests that nivolumab combined with ipilimumab may retain efficacy even after multiple prior ICI failures.
SN - 1349-7235
SN - 0918-2918
ER -