Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Cases. May 26, 2026; 14(15): 119781
Published online May 26, 2026. doi: 10.12998/wjcc.v14.i15.119781
Published online May 26, 2026. doi: 10.12998/wjcc.v14.i15.119781
Dramatic response to fourth-line ramucirumab after atezolizumab plus bevacizumab failure in advanced hepatocellular carcinoma: A case report
Masanori Fukushima, Yasuhiko Nakao, Ryu Sasaki, Masafumi Haraguchi, Satoshi Miuma, Hisamitsu Miyaaki, Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528501, Japan
Author contributions: Fukushima M designed the report and determined the clinical significance of the case; Fukushima M, Nakao Y, Sasaki R, Haraguchi M, and Miuma S collected and analyzed the clinical and imaging data; Fukushima M analyzed the data and wrote the manuscript; Fukushima M treated the patient in this case; Miuma S and Miyaaki H supervised the clinical interpretation and manuscript development; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Masanori Fukushima, MD, PhD, Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 8528501, Japan. ma-fukushima@nagasaki-u.ac.jp
Received: February 24, 2026
Revised: March 13, 2026
Accepted: April 8, 2026
Published online: May 26, 2026
Processing time: 85 Days and 1.8 Hours
Revised: March 13, 2026
Accepted: April 8, 2026
Published online: May 26, 2026
Processing time: 85 Days and 1.8 Hours
Core Tip
Core Tip: Hepatocellular carcinoma with elevated alpha-fetoprotein levels that progresses after treatment with atezolizumab plus bevacizumab may involve enhanced vascular endothelial growth factor receptor-2 signaling, making ramucirumab a potentially effective treatment option.