# Case Report: Long-term disease-free survival in an advanced hepatocellular carcinoma patient: an exceptional response to PD-1 inhibitor therapy

## TL;DR

A patient with advanced liver cancer achieved long-term remission using a reduced dose of a PD-1 inhibitor, offering hope for similar treatments.

## Contribution

Demonstrates exceptional long-term disease-free survival with reduced-dose PD-1 inhibitor in advanced HCC.

## Key findings

- A 55-year-old male achieved complete remission after four cycles of reduced-dose pembrolizumab.
- The patient remained disease-free for over seven years, highlighting the potential of personalized dosing.
- The case provides insights into managing immune-related adverse events with PD-1 inhibitors.

## Abstract

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death, with most patients diagnosed at advanced stages, often precluding surgical resection. Recently, immune checkpoint inhibitors, particularly PD-1 inhibitors, have emerged as promising therapies, though long-term disease-free survival (DFS) remains rare. We report a case of an advanced HCC patient who achieved complete remission (CR) after just four cycles of reduced-dose pembrolizumab and maintained a disease-free status for more than seven years.

A 55-year-old male with chronic hepatitis B and alcohol-related liver disease presented with a ruptured HCC. After initial treatments, including surgery and chemotherapy, the patient was started on reduced-dose pembrolizumab (100 mg). After four cycles, the patient achieved CR.

This case highlights the potential for long-term survival with reduced-dose PD-1 inhibitor therapy in advanced HCC. The patient’s exceptional response provides important insights into the role of personalized dosing, immune checkpoint inhibitors, and the management of immune-related adverse events.