{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T01:14:29Z","timestamp":1778030069288,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fibrolamellar hepatocellular carcinoma (FL\u2010HCC) clinically occurs in young people aged 20\u201330\u2009years, who often have a normal liver background. We propose a treatment for such cases in which a combination therapy of atezolizumab and bevacizumab is followed by sandwiching radiation therapy to release tumor antigens and then re\u2010administering the combination therapy of atezolizumab and bevacizumab (ABC conversion therapy).<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>The patient is a 15\u2010year\u2010old girl. On April 18, 2022, she noticed skin yellowing and visited her local doctor. Computed tomography (CT) revealed a large mass in the right lobe of the liver and bile duct obstruction due to the tumor. She also had a nodule on her chest that appeared to be a metastatic tumor and was referred to Kinki University Hospital in April 2023. She was suspected to have FL\u2010HCC based on contrast\u2010enhanced ultrasound and CT scan results. There were findings suggestive of lung metastasis; however, she underwent a right hepatic lobectomy on May 17, 2023, considering the risk of liver failure and intra\u2010abdominal bleeding due to the large liver tumor. A CT scan conducted on July 25, 2022, showing increased lung metastases, and she started atezolizumab\/bevacizumab combination treatment on October 20, 2022. On March 15, 2023, multiple lung metastases and new intrahepatic lesions appeared, which was diagnosed as progressive disease (PD), and lenvatinib was discontinued. On November 17, 2023, radiation therapy (25\u2009Gy\/5\u2009Fr) was administered to the lung and intrahepatic lesions to release tumor antigens, and on November 27, 2023, atezolizumab and bevacizumab combination treatment was resumed to control the tumor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combination therapy with atezolizumab, bevacizumab, and radiation therapy may be an option for the treatment of FL\u2010HCC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.70090","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T04:40:21Z","timestamp":1734669621000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Case of Fibrolamellar Hepatocellular Carcinoma in Which Tumor Control Was Achieved by Re\u2010Administering Atezolizumab and Bevacizumab"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3412-4701","authenticated-orcid":false,"given":"Satoru","family":"Hagiwara","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itsuki","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuomi","family":"Ueshima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0068-8461","authenticated-orcid":false,"given":"Yoriaki","family":"Komeda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoshi","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoki","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Omaru","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatoshi","family":"Kudo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"168","article-title":"Differential Diagnosis of Tumors and Tumor\u2010Like Lesions of Liver in Infancy and Childhood","volume":"91","author":"Edmondson H. 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