Dramatic response to fourth-line ramucirumab after atezolizumab plus bevacizumab failure in advanced hepatocellular carcinoma: A case report

doi:10.12998/wjcc.v14.i15.119781

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May 26, 2026 (publication date) through May 12, 2026

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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

Table 1 Laboratory data at each treatment initiation and 14 months after ramucirumab

Parameter	Reference range	Atez/Bev	LEN	SOR	RAM	RAM (14 months)
WBC (μL)	3300-8600	4900	3500	6100	5300	6000
Hb (g/dL)	13.7-16.8	14.5	13.7	13.9	13.4	11.8
Plt (× 10⁴/μL)	15.8-34.8	19.2	22.7	22.3	29.2	14.4
PT-INR	1.00	1.14	1.23	1.07	1.19	0.98
TBIL (mg/dL)	0.4-1.5	1.0	1.1	0.9	1.3	0.7
Alb (g/dL)	4.1-5.1	3.8	3.2	3.4	2.6	3.3
AST (U/L)	13-30	33	37	47	65	42
ALT (U/L)	10-42	25	18	47	26	15
ALP (U/L)	38-113	145	96	153	194	137
GGT (U/L)	13-64	77	116	195	213	108
Child-Pugh score		5	7	6	7	6
ALBI score		-2.42	-1.88	-2.11	-1.32	-2.09
AFP (ng/mL)	< 7	99.5	260	692	714	2.3
DCP (mAU/mL)	< 28	1897	34797	19206	> 75000	161

WBC: White blood cell; Hb: Hemoglobin; Plt: Platelet; PT-INR: Prothrombin time-international normalized ratio; TBIL: Total bilirubin; Alb: Albumin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; ALBI: Albumin-bilirubin; AFP: Alpha-fetoprotein; DCP: Des-gamma carboxy prothrombin; Atez/Bev: Atezolizumab plus bevacizumab; LEN: Lenvatinib; SOR: Sorafenib; RAM: Ramucirumab.

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Citation: Fukushima M, Nakao Y, Sasaki R, Haraguchi M, Miuma S, Miyaaki H. Dramatic response to fourth-line ramucirumab after atezolizumab plus bevacizumab failure in advanced hepatocellular carcinoma: A case report. World J Clin Cases 2026; 14(15): 119781
URL: https://www.wjgnet.com/2307-8960/full/v14/i15/119781.htm
DOI: https://dx.doi.org/10.12998/wjcc.v14.i15.119781