My husband has been on Avastin/Tecentric q3wks since August 2020 with stable scans and AFP dropping from 600 to 262 until this week when there's a new area of uptake 2.5-3 cm that both oncologist/IR thinks is new area of cancer outside of portal vein but not well defined yet. They both rec repeat scans in 2 months rather than changing tx yet as has had good quality of life and response to Avastin/Tecentriq. Avastin had to be held this week due to concerns of interfering with healing of a surgical drainage of an abscess which makes us more nervous since it is the tumor inhibitor. We will meet with oncologist next week to discuss when can resume. IR thinks Y90 will be needed but responds better if a little larger as more vascular and is in an area that is easy to get to with Y90 and he thinks needs to "declare itself." IR sees us after every scan so very familiar and always discusses with oncologist so feel we have an excellent team who think outside the box though not a major cancer center. Questions: 1- anyone else experience with MD's taking watch/wait approach as this is the largest area to appear since dx 2018 so making us nervous. 2-Anyone with experience with Opdivo/Yervoy? discussed Opdivo/Yervoy in past but due to known high side effects wanted to postpone this option 3-Anyone with MD going back to a treatment that worked for awhile but stopped working---in our case Linvema which worked for 9 mos.
History: Diagnosed March 2018 inoperable HCC 8cm with portal vein involvement -- treated with Linvema and Y90 that killed the tumor in the portal vein and shrunk the main tumor. other small nodules present but stable AFP 64 went to normal. January 2020 scans showed live tumor around the rim of the dead main tumor and smaller ones had started growing. Switched to Opdivo, repeat Y90 and had irritation of liver with fluid accumulation that had to be drawn off but no recurrence of ascites since. AFP started increasing with no correlation on scans, added Sorafenib to Opdivo at half dose as couldn't tolerate full and AFP kept increasing to over 600 though minimal change in scans. MD's concerned there was something occurring so changed to Avastin/Tecentriq in August and has done well until current scan. Our MD's have been proactive with using systemic and locoreg treatment together. We are just having a hard time with watch/wait since this is biggest area to appear since diagnosis though not yet fully delineated so any input/experience appreciated!! Thankyou!!!
Updated information causing confusion
Experiences with TARE?
