Abstract
BACKGROUND: Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma (HCC) since 2008. While radiological complete responses are extremely rare, improved supportive care and multidisciplinary approaches in clinical practice may explain the recent increase in case reports and retrospective series documenting such responses. CASE SUMMARY: This case series describes 3 patients with advanced HCC who achieved durable complete responses using first-line sorafenib therapy, even in the presence of portal vein thrombosis or extrahepatic spread, and highlights the potential for sustained remission in selected patients. Dermatologic toxicity and non-viral etiology may correlate with favorable outcomes; however, reliable predictive biomarkers for sorafenib response are lacking. CONCLUSION: Future research into the etiology and molecular differences in HCC is necessary to develop more personalized therapy options.