# Treating an Advanced Combined Hepatocellular-Cholangiocarcinoma with a Multikinase Inhibitor

## TL;DR

This paper describes a case of an aggressive liver cancer treated with a multikinase inhibitor, lenvatinib, in a patient with advanced disease.

## Contribution

The novelty lies in reporting lenvatinib's use in treating advanced combined hepatocellular-cholangiocarcinoma, a rare cancer with no standard treatment.

## Key findings

- The patient received lenvatinib as treatment for advanced cHCC-CC with metastasis.
- The treatment was initiated due to the lack of consensus on optimal systemic therapy for this rare cancer.

## Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is an aggressive hepatic cancer that has characteristics of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). For resectable disease, liver resection is the preferred first treatment option. As for the advanced or metastatic setting, and due to its rarity, there is still no consensus on which is the optimal systemic treatment. As such, regimens used in both HCC and CC have often been used as first-line treatment options. We report a case of a male patient in his 50s, diagnosed with a cHCC-CC with lymph node and adrenal metastasis, with an extensive portal vein tumour thrombosis, that started treatment with a multikinase inhibitor - lenvatinib.