A Case of Unresectable Hepatocellular Carcinoma Responding to Durvalumab Plus Tremelimumab after Lenvatinib Treatment.

We report a case of unresectable hepatocellular carcinoma (HCC) that responded to durvalumab plus tremelimumab after disease progression during atezolizumab monotherapy and intolerance to lenvatinib. A 74-year-old man with a Child-Pugh A liver function developed multifocal HCC that was refractory to prior therapies. Tumor markers transiently increased after durvalumab plus tremelimumab initiation, followed by normalization and radiological tumor shrinkage without any new lesions. This response may be associated with lenvatinib-mediated modulation of the tumor microenvironment and/or immune activation induced by CTLA-4 blockade.