Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) is a highly malignant tumor of the digestive system with a poor prognosis. Huge HCC, a subtype characterized by tumors measuring at least 10 cm in diameter, often presents with macrovascular invasion, satellite nodules, metastases, and other aggressive characteristics, posing significant challenges for treatment. The era of combined targeted therapy and immunotherapy has brought new hope to patients with advanced HCC. The development of innovative combination medication regimens for HCC is a current area of intense clinical research interest. We are trying to explore new combination therapies based on target-immunity combination therapy in the hope of better-benefiting patients with advanced huge HCC. CASE DESCRIPTION: We present a patient with Barcelona Clinical Liver Cancer Stage C huge HCC who was treated with combined targeted therapy and immunotherapy as the primary therapeutic regimen, supplemented with tegafur long-term metronomic chemotherapy, as well as specialized adjuvant therapy such as thymosin, bisphosphonates, antiviral medication, and vitamin C supplementation. The tumor size was significantly reduced and microwave ablation was performed, after which, the patient was kept on the combination regimen, resulting in a partial response (PR), and maintaining PR without disease progression for 32 months. CONCLUSIONS: The combination regimen may enhance advanced huge HCC treatment and provide a new multimodal drug strategy for HCC.