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Sustained complete response of advanced hepatocellular carcinoma with metronomic capecitabine: a report of three cases

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"Case presentation: We describe three cases of advanced HCC treated with metronomic capecitabine where a CR was obtained. In the first case, capecitabine was administered as first line therapy; in the second case, capecitabine was used after intolerance to sorafenib; while in the third case, capecitabine was administered after sorafenib failure.

Conclusion: Capecitabine is a potentially important treatment option for patients with advanced HCC and may even represent a cure in certain cases.

Case 1: 
Treatment: In January 2010, as a consequence of disease metastasis, systemic treatment with metronomic capecitabine (500 mg twice daily) was continuously administered according to a previously described protocol
Results: The final MRI (February 2017, Fig. 1c, d) confirmed the Complete Remission. To date, the patient is alive and in good health.

Case 2:
Treatment: In January 2013, the patient started metronomic capecitabine (500 mg twice daily, continuous administration), which was well-tolerated. 
Results: In the most recent US scan (September 2017), no hepatic lesion was detected and serum AFP was 3.6 ng/mL. The patient is currently alive and in excellent health.

Case 3:
Treatment: In February 2016, following radiological progression (tumoural invasion of the right and median hepatic veins and enlargement of the neoplastic thrombus in the inferior cava vein) and a sharp increase in serum AFP (47,137 ng/mL), the patient was switched to capecitabine therapy (500 mg twice daily, continuous administration). 
Results: At the time of writing, the patient is in good clinical condition and continues to receive capecitabine treatment (500 mg bid), complaining only of modest fatigue."