Efficacy of lenvatinib plus pembrolizumab in hepatocellular carcinoma with metachronous lung metastasis: a report of two cases

Introduction: Immune checkpoint inhibitors (ICIs) and a combination of ICIs with targeted antiangiogenic agents are effective in treatment of advanced hepatocellular carcinoma (HCC). Studies have not explored effective biomarkers for prediction of HCC sensitivity to immunotherapy. Case description: The current study explored two consecutive patients with HCC with metachronous lung metastasis who were treated with lenvatinib and pembrolizumab as first-line treatment and third-line treatment, respectively. The two cases showed significant tumor shrinkage and long progression-free survival (>19 months and 12 months, respectively). Conclusions: The findings of the current study and recently published data indicate lung metastasis as a potential clinical therapeutic indicator for efficacy of immunotherapy against HCC.