Camrelizumab plus sorafenib or apatinib achieved long-term survival in a patient with hepatocellular carcinoma and an Eastern Cooperative Oncology Group performance status of 3: a case report
Case Report: iMDT Corner

Camrelizumab plus sorafenib or apatinib achieved long-term survival in a patient with hepatocellular carcinoma and an Eastern Cooperative Oncology Group performance status of 3: a case report

Xin Wang1, Guangbin Ji1, Xi Chen1, Hongbo Hu1, Lianyue Zou1, Haruhiko Takeda2, Caiyun Zhou3

1Department of Medical Oncology, General Hospital of Benxi Iron and Steel Industry Group of Liaoning Health Industry Group, Benxi, China; 2Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; 3Huludao Cancer Quality Control Center, The Fourth Oncology Department, Huludao Central Hospital, Huludao, China

Contributions: (I) Conception and design: X Wang; (II) Administrative support: X Wang; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Correspondence to: Caiyun Zhou, BMed. Huludao Cancer Quality Control Center, The Fourth Oncology Department, Huludao Central Hospital, 15 Lianshan Street, Lianshan District, Huludao 125000, China. Email: zhoucaiyun123@aliyun.com.

Background: Hepatocellular carcinoma (HCC) remains a global health burden, with limited therapeutic options for patients with poor Eastern Cooperative Oncology Group performance status (ECOG PS). Current guidelines recommend best supportive care (BSC) for patients with HCC and an ECOG PS ≥3, as systemic therapies such as tyrosine kinase inhibitors (TKIs) or immune checkpoint inhibitors (ICIs) are typically restricted to PS 0–1 population. To our knowledge, this may be the first reported case suggesting that targeted therapy combined with ICIs could be feasible and potentially beneficial in a patient with HCC and an ECOG PS of 3.

Case Description: A 47-year-old male with hepatitis B-related HCC presented in August 2018 with an 80 mm × 69 mm right hepatic lobe tumor, an ECOG PS of 2, and Child-Pugh class A. He underwent curative resection and adjuvant transcatheter arterial chemoembolization (TACE). In December 2020, recurrence was noted with the tumor lesion measuring 130 mm × 120 mm with accompanying portal vein cancer thrombosis. His ECOG PS was 3 (bedridden >50% of the day), the alpha fetoprotein (AFP) level was >1,000 IU/mL, and the cancer antigen 125 (CA125) level was 118 U/mL. Despite contraindications, sorafenib was initiated but failed to improve symptoms or tumor markers. In February 2021, camrelizumab (21-day cycles) was added to ongoing sorafenib. By May 2021, the ECOG PS improved to 1, and he experienced partial response (PR) according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, and the tumor had shrunk to 87 mm × 64 mm. AFP normalized to 1.63 IU/mL by September 2023. Sorafenib was replaced with apatinib in February 2023 due to rash, but PR was maintained. At the follow-up in March 2025, the patient was alive with a 49-month progression-free survival (PFS) from camrelizumab initiation, stable disease (49 mm × 40 mm), and normal AFP and CA125 levels. Key baseline biomarkers included a neutrophil-to-lymphocyte ratio (NLR) of 3.67 and an albumin-bilirubin (ALBI) grade of 1. Treatment adherence was complicated by financial interruptions but resumed with a combination of apatinib plus camrelizumab.

Conclusions: This case may provide preliminary support for the potential use of targeted therapy combined with immune checkpoint inhibitors in patients with HCC and an ECOG performance status of 3.

Keywords: Hepatocellular carcinoma (HCC); performance status (PS); long-term survival; camrelizumab; case report

Submitted Jun 03, 2025. Accepted for publication Jun 24, 2025. Published online Jun 27, 2025.

doi: 10.21037/jgo-2025-433

Highlight box

Key findings

• This case report documents a 47-year-old male with hepatitis B-related hepatocellular carcinoma (HCC) and Eastern Cooperative Oncology Group performance status (ECOG PS) of 3 who achieved a 49-month progression-free survival (PFS) with camrelizumab combined with sorafenib and apatinib.

What is known and what is new?

• Current guidelines restrict systemic therapy (e.g., sorafenib and immune checkpoint inhibitors) to patients with HCC with ECOG PS 0–1, recommending best supportive care for PS ≥3. There are limited data on the long-term outcomes of systemic therapy in patients with a PS of 3.

• This report is the first to demonstrate durable response (49-month PFS) in a patient with a PS of 3 treated with camrelizumab-based combinations, suggesting that select patients with a PS of 3 may benefit from these therapies, particularly those with favorable biomarkers (neutrophil-to-lymphocyte ratio <5 and albumin-bilirubin grade 1).

What is the implication, and what should change now?

• This case underscores the need to reassess eligibility criteria for systemic therapy in patients with HCC with a PS ≥3 and prioritize biomarker-driven trials to identify responders. Recommended actions include the following: designing clinical trials explicitly including patients with PS ≥3 to validate safety and efficacy; and exploring the integration of local therapies (e.g., transarterial chemoembolization) with systemic regimens.

• These efforts would address a critical unmet need and advance precision oncology for HCC.

Introduction

Primary liver cancer is the sixth most prevalent malignancy worldwide, with the third highest mortality rate. In 2020, the global incidence of the disease was approximately 906,000 cases, and 830,000 related deaths were recorded (1). Primary liver cancer encompasses a spectrum of pathologies, including hepatocellular carcinoma (HCC) (accounting for 75–85% of cases) and intrahepatic cholangiocarcinoma (10–15%) in addition to other less prevalent forms (1). In China, surgical resection is the preferred treatment for patients with China Liver Cancer Staging (CNLC) Ia–IIa, and best supportive care (BSC) is recommended for patients with Eastern Cooperative Oncology Group performance status (ECOG PS) 3–4, as recommended by the Barcelona Clinic Liver Cancer (BCLC) group (2-4). Prior to 2023, the first-line systemic therapy recommended by the guidelines for HCC in mainland China is sorafenib and lenvatinib, but only for patients with ECOG PS 0–1 (2,4).

Approximately 30% of patients with HCC are diagnosed at an early stage, and hepatectomy followed by adjuvant transcatheter arterial chemoembolization (TACE) has not been found to prolong the recurrence-free survival (RFS) and overall survival (OS) of patients with stage I or II HCC (5,6). Sorafenib is one of the most commonly used first-line systemic treatments for HCC, with a Response Evaluation Criteria in Solid Tumors (RECIST) median time to progression (TTP) of 2.8 months [95% confidence interval (CI): 2.63–3.58] (2,7). In a report on recurrent HCC, the median time to progression for camrelizumab monotherapy evaluated according to RECIST version 1.1 was 2.3 months (95% CI: 2.0–3.3) (8). Another study reported that apatinib monotherapy achieved a RECIST version 1.1 median progression-free survival (PFS) of 4.5 months for patients with HCC in second-or-later-line treatment (95% CI: 3.9–4.7) (9). Other research indicated a median PFS of 5.5 months (95% CI: 3.7–7.3) for second-line treatment of HCC with apatinib, which was assessed by an independent review committee via the modified RECIST (mRECIST) (10). A systematic review and meta-analysis in 2024 found that patients with HCC with and an ECOG PS (≥1) treated with immune checkpoint inhibitors (ICIs) experience worse OS (11). To the best of our knowledge, there is no literature reporting the long-term survival of a patient with HCC and poor ECOG PS after systemic therapy alone.

To our knowledge, this may be the first case report suggesting that targeted therapy combined with immune checkpoint inhibitors could be feasible and potentially beneficial in a patient with HCC and an ECOG performance status of 3, offering preliminary insight into possible treatment options for this understudied population. We present this article in accordance with the CARE reporting checklist (available at https://jgo.amegroups.com/article/view/10.21037/jgo-2025-433/rc).

Case presentation

In August 2018, a 47-year-old male patient with a history of hepatitis B visited our hospital (Department of Medical Oncology, General Hospital of Benxi Iron and Steel Industry Group of Liaoning Health Industry Group) due to progressive weight loss. Enhanced computed tomography (CT) suggested HCC in the right lobe of the liver measuring 80 mm × 69 mm. Hepatitis B surface antigen was positive, and the alpha fetoprotein (AFP) level was 24.06 IU/mL. This patient had no hepatic encephalopathy or no ascites; the level of bilirubin was 25.7 µmol/L, the albumin level was 37 g/L, the prothrombin time (PT) time was 10.8, the Child-Pugh classification was A (5 points), and the ECOG PS was 2. The patient then underwent hepatic tumor resection at another tertiary care oncology hospital. Postoperative pathology confirmed HCC. The immunohistochemistry results were as follows: AFP (+), Hep (+), GPC3 (+), CD34 (+), CD10 (+), CK19 (−), CEA (−), cancer antigen (CA)199 (−), Hep-1 (+), CK8 (+), and CK18 (+). Postoperative adjuvant TACE was performed once.

In December 2020, the patient had discomfort in the liver area and diarrhea more than 10 times/day with no improvement after symptomatic treatment. Enhanced CT of the liver showed recurrent HCC with portal vein cancer thrombosis and a tumor size 130 mm × 120 mm. As a result, the patient was diagnosed with CNLC stage IIIa. The AFP level was >1,000 IU/mL, and the cancer antigen 125 (CA125) was 118 U/mL. There was no hepatic encephalopathy or ascites. The bilirubin level was 27.3 µmol/L, the albumin level was 33.5 g/L, the PT was 11.7 seconds, and the Child-Pugh classification was grade A (6 points). The patient felt very weak, was in bed >50% of the day, and was therefore assessed as having an ECOG PS of 3. Due to the patient’s strong desire to receive antitumor therapy despite an ECOG PS score of 3, the patient was subsequently started on sorafenib 200 mg orally twice daily. However, over the next 2 months, there was no relief of hepatic discomfort or diarrhea and no decrease in tumor marker levels. In January 2021, the neutrophil count was 7.31×109/L, the lymphocyte count was 1.99×109/L, and the neutrophil-to-lymphocyte ratio (NLR) was 3.67. The albumin level was 45.3 g/L, the total bilirubin level was 15.2 µmol/L, and the albumin-bilirubin (ALBI) score was −3.07, with an ALBI classification of grade 1. In February 2021, the AFP level was >1,000 IU/mL, the CA125 level was 398.9 U/mL, and the cancer antigen 199 (CA199) was 31.07 U/mL.

In February 2021, the patient was started on camrelizumab for 21 days/cycle according to the guidelines for mainland China (2). The patient refused to discontinue sorafenib, even though it is off-label. In May 2021, the patient’s hepatic discomfort and diarrhea were significantly reduced, and the patient was able to walk around freely but still felt physically weak, and his ECOG PS was 1. Follow-up liver images in July 2021, January 2022, and February 2023 showed lesions measuring 87 mm × 64 mm, 70 mm × 60 mm, and 47 mm × 50 mm, respectively, and the efficacy was assessed as partial response (PR) according to RECIST 1.1. Between May and July 2022, the patient discontinued sorafenib due to an extensive rash with pruritus, which was discontinued intermittently thereafter. In February 2023, the patient again developed a generalized, extensive rash, so sorafenib was changed to apatinib (500 mg orally once daily) (9). The patient declined to discontinue camrelizumab because he had no significant ICI-related adverse events (AEs). In March 2023, the patient went to the surgical department of another hospital to inquire about the possibility of surgical resection but was advised his condition was inoperable and that he should continue on camrelizumab treatment. From April to September 2023, the patient discontinued apatinib and camrelizumab due to financial reasons. In September 2023, a follow-up liver image showed a lesion measuring 49 mm × 40 mm, the AFP level was 1.63 IU/mL, the CA125 level was 26.47 U/mL, and the CA199 level was 27.13 U/mL. From September 2023, the patient’s treatment regimen was changed to apatinib (500 mg orally once daily) plus camrelizumab (200 mg, 2-month cycle). In March 2025, follow-up imaging showed no evidence of tumor enhancement, consistent with a complete response according to mRECIST. The patient had achieved a PFS of over 49 months since the initiation of camrelizumab. The patient’s course of treatment and AFP changes are illustrated in Figure 1. All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee(s) and with the Declaration of Helsinki and its subsequent amendments. Written informed consent for publication of this case report and accompanying images was provided by the patient. A copy of the written consent is available for review by the editorial office of this journal.

Figure 1 Timeline of laboratory findings, treatments, and imaging. AFP, alpha fetoprotein; ECOG PS, Eastern Cooperative Oncology Group performance status; HCC, hepatocellular carcinoma; mRECIST, modified Response Evaluation Criteria in Solid Tumors; TACE, transarterial chemoembolization.

International multidisciplinary team (iMDT) discussion

Discussion from the General Hospital of Benxi Iron and Steel Industry Group of Liaoning Health Industry Group, The Fourth Oncology Department, Huludao Central Hospital

In our treatment of a patient with HCC and a ECOG PS score of 3, we found that camrelizumab in combination with sorafenib or apatinib achieved long survival and an acceptable safety profile in HCC patients with ECOG PS score 3.

To the best of our knowledge, this is the first case report of a patient with HCC and an ECOG PS score of 3 who was treated with targeted therapy in combination with an ICI and achieved long survival. The patient only received systemic therapy, not interventional therapy, so it can be expected that the benefit of long-term survival was due to systemic therapy.

The vast majority of phase III clinical trials on systemic therapy for patients with unresectable HCC included only those with an ECOG PS of 0–1, and the phase III study of sorafenib included eight patients with ECOG PS scores of 2 (7,12-14). Patients with HCC without macroscopic vascular invasion, without extrahepatic spread, or with an ECOG PS score 1–2 have a lower risk of death when treated with first-line sorafenib (7). Moreover, camrelizumab plus rivoceranib has been shown to provide longer OS as compared with sorafenib in predefined subgroups including age <65 years of age and males (12). The post hoc analysis of the CARES-310 study indicated that patients with HCC receiving first-line treatment with camrelizumab plus rivoceranib and with a baseline NLR <5 and ALBI grade 1 may experience better OS (15,16). In a retrospective study, median OS was not statistically different between patients treated with camrelizumab plus sorafenib and those treated with sorafenib after propensity score matching (14.1 vs. 9.6 months; P=0.105), but the median PFS was significantly prolonged (9.5 vs. 4.7 months; P=0.043) (17). Emerging case report suggest that a marked decrease in tumor burden, combined with subsequent maintenance treatment using camrelizumab and apatinib, may contribute to sustained disease remission in patients with HCC (18).

In our case, the patient was considered insensitive to sorafenib due to a lack of symptomatic relief on the initial administration of sorafenib alone and the progressive elevation of AFP. A subsequent PFS of 2 years was obtained with the addition of camrelizumab to sorafenib, which might have resulted from the benefit of a targeted immunotherapy (17). Moreover, the patient’s NLR being <5 and the ALBI classification of grade 1 may also explain the longer survival. The patient’s treatment regimen was changed to camrelizumab plus apatinib and thus far has achieved a PFS of 49 months; however, since there are no previous cases of long-term survival yielded by the short-term use of camrelizumab plus apatinib, it is uncertain whether apatinib had a role in the survival of the patient in this case (18).

It may be beneficial for this patient to consult an interventionalist to determine if the tumor can be further intervened with local treatments such as hepatic arterial infusion chemotherapy or TACE and to evaluate the tumor activity of the lesion according to the mRECIST. This could further clarify the cause of the patient’s long-term survival benefit. If interventional therapy is performed next and achieves a degree efficacy, further consultation with a surgical specialist may be warranted to assess the feasibility of radical surgery.

This study has several limitations. As a case report, it lacks statistical robustness and cannot be extrapolated to broader patient populations. Favorable baseline characteristics may have contributed to the treatment response, but their predictive value remains unconfirmed. The treatment course involved regimen changes and interruptions, introducing confounding factors that complicate efficacy attribution. Additionally, the absence of standardized imaging criteria such as mRECIST and a comparator arm limits the strength of causal inferences. Further prospective studies are warranted to clarify long-term outcomes and establish evidence in patients with poor performance status.

Several issues on the treatment of these patients were further discussed as follows

  • Question 1: should this patient’s immunotherapy be maintained or terminated?
    Haruhiko Takeda: since normalization of AFP and disappearance of early enhancement on contrast-enhanced CT have been sustained for more than 1 year, immunotherapy can be considered to be terminated. It is advisable to make a comprehensive judgment, taking into consideration the fact that there was a period of interruption due to financial problems. If the immunotherapy is considered to be terminated, regular follow-up with periodic tumor markers and CT should be necessary.
  • Question 2: can this patient be classified as having achieved a clinical complete remission (CR), given that the enhanced magnetic resonance imaging (MRI) from December 2024 revealed no evidence of tumor enhancement?
    Haruhiko Takeda: the patient is evaluated to be PR by RECIST1.1. However, if there was no tumor enhancement in all cross sections and tumor markers remained normal, the patient could be determined CR by mRECIST. If possible, it is recommended to evaluate the blood flow in the tumor area by dynamic study using Sonazoid contrast-enhanced ultrasound (US).
  • Question 3: is this patient a candidate for surgical intervention?
    Haruhiko Takeda: the tumor is not enhanced in the CT scan, and is shrinking, and there may be no viable tumor cells remaining at this point. Considering the invasiveness of surgery and the possibility of future recurrence at other liver sites, the patient should be cautious about being a candidate for surgical resection.
  • Question 4: the optimal sequencing of targeted-immunotherapy and interventional therapy for future patients with comparable disease profiles.
    Haruhiko Takeda: if immunotherapy is not feasible due to the development of immune-related AEs, there is the option of switching to local interventional therapy. Targeted-immunotherapy can be started again after adequate steroid reduction for irAEs.
  • Question 5: which patient populations are likely to derive greater benefit from targeted-immunotherapy?
    Haruhiko Takeda: there is no definitive biomarker that predicts patient populations likely to derive greater benefit from targeted-immunotherapy. However, in our recent studies using clinical data, patients with high NLR and CRAFITY score of 2 were reported to have poor response to immunotherapy, which may be useful for patient selection (19,20), although the treatment regimen is different from the current case.

Conclusions

For patients with an ECOG PS score of 3, the combination of different targeted therapies based on camrelizumab may provide a long-term survival benefit, but the exact reasons for this benefit still need to be clarified in a large number of basic studies and validated in additional clinical trials.

Acknowledgments

We would like to thank Yang Wang (a medical writer at Suzhou Suncadia Biopharmaceuticals Co., Ltd.) for technical editing.

Footnote

Reporting Checklist: The authors have completed the CARE reporting checklist. Available at https://jgo.amegroups.com/article/view/10.21037/jgo-2025-433/rc

Peer Review File: Available at https://jgo.amegroups.com/article/view/10.21037/jgo-2025-433/prf

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-2025-433/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee(s) and with the Declaration of Helsinki and its subsequent amendments. Written informed consent for publication of this case report and accompanying images was provided by the patient. A copy of the written consent is available for review by the editorial office of this journal.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

  1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209-49. [Crossref] [PubMed]
  2. Xie DY, Ren ZG, Zhou J, et al. 2019 Chinese clinical guidelines for the management of hepatocellular carcinoma: updates and insights. Hepatobiliary Surg Nutr 2020;9:452-63. [Crossref] [PubMed]
  3. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol 2022;76:681-93. [Crossref] [PubMed]
  4. Zhou J, Sun H, Wang Z, et al. Guidelines for the Diagnosis and Treatment of Primary Liver Cancer (2022 Edition). Liver Cancer 2023;12:405-44. [Crossref] [PubMed]
  5. Llovet JM, Pinyol R, Yarchoan M, et al. Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma. Nat Rev Clin Oncol 2024;21:294-311. [Crossref] [PubMed]
  6. Ma T, Bai X, Zhang Q, et al. Adjuvant transarterial chemoembolization for hepatocellular carcinoma following curative resection: A randomized, open-label, phase 3 trial. Hepatology 2025; Epub ahead of print. [Crossref]
  7. Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol 2009;10:25-34. [Crossref] [PubMed]
  8. Qin S, Ren Z, Meng Z, et al. Camrelizumab in patients with previously treated advanced hepatocellular carcinoma: a multicentre, open-label, parallel-group, randomised, phase 2 trial. Lancet Oncol 2020;21:571-80. [Crossref] [PubMed]
  9. Qin S, Li Q, Gu S, et al. Apatinib as second-line or later therapy in patients with advanced hepatocellular carcinoma (AHELP): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Gastroenterol Hepatol 2021;6:559-68. [Crossref] [PubMed]
  10. Xu J, Shen J, Gu S, et al. Camrelizumab in Combination with Apatinib in Patients with Advanced Hepatocellular Carcinoma (RESCUE): A Nonrandomized, Open-label, Phase II Trial. Clin Cancer Res 2021;27:1003-11. [Crossref] [PubMed]
  11. Han CL, Tian BW, Yan LJ, et al. The effect of age, sex, and eastern cooperative oncology group performance status on the efficacy and safety of immune checkpoint inhibitors in patients with hepatocellular carcinoma: a systematic review and meta-analysis. Expert Rev Anticancer Ther 2024;24:303-12. [Crossref] [PubMed]
  12. Qin S, Chan SL, Gu S, et al. Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): a randomised, open-label, international phase 3 study. Lancet 2023;402:1133-46. [Crossref] [PubMed]
  13. Abou-Alfa GK, Lau G, Kudo M, et al. Tremelimumab plus Durvalumab in Unresectable Hepatocellular Carcinoma. NEJM Evid 2022;1:EVIDoa2100070.
  14. Qin S, Ren Z, Feng YH, et al. Atezolizumab plus Bevacizumab versus Sorafenib in the Chinese Subpopulation with Unresectable Hepatocellular Carcinoma: Phase 3 Randomized, Open-Label IMbrave150 Study. Liver Cancer 2021;10:296-308. [Crossref] [PubMed]
  15. Burgoyne A, Kaseb AO, Shi W, et al. Role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte-ratio (PLR) in unresectable hepatocellular carcinoma (uHCC): Subgroup analysis of patients treated with camrelizumab (cam) + rivoceranib (rivo) in the CARES-310 trial. J Clin Oncol 2024;42:e16197.
  16. Vogel A, Cheng AL, Shi W, et al. Impact of baseline liver function on survival outcomes in patients with unresectable hepatocellular carcinoma (uHCC) treated with camrelizumab + rivoceranib vs sorafenib: A post hoc analysis of study CARES-310. J Clin Oncol 2024;42:509.
  17. Liu Q, You N, Li J, et al. Camrelizumab Plus Sorafenib Versus Sorafenib Monotherapy for Advanced Hepatocellular Carcinoma: A Retrospective Analysis. Front Oncol 2021;11:694409. [Crossref] [PubMed]
  18. Qiao JH, Wang Y, Fu CX, et al. Complete response and long-term survival after short-course camrelizumab plus apatinib, hepatic arterial infusion chemotherapy, and transarterial chemoembolization in large and advanced hepatocellular carcinoma: a case report. J Gastrointest Oncol 2024;15:2323-9. [Crossref] [PubMed]
  19. Eso Y, Takeda H, Taura K, et al. Pretreatment Neutrophil-to-Lymphocyte Ratio as a Predictive Marker of Response to Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma. Curr Oncol 2021;28:4157-66. [Crossref] [PubMed]
  20. Ueno M, Takeda H, Takai A, et al. CRAFITY score as a predictive marker for refractoriness to atezolizumab plus bevacizumab therapy in hepatocellular carcinoma: a multicenter retrospective study. J Gastroenterol 2024;59:1107-18. [Crossref] [PubMed]

(English Language Editor: J. Gray)

Cite this article as: Wang X, Ji G, Chen X, Hu H, Zou L, Takeda H, Zhou C. Camrelizumab plus sorafenib or apatinib achieved long-term survival in a patient with hepatocellular carcinoma and an Eastern Cooperative Oncology Group performance status of 3: a case report. J Gastrointest Oncol 2025;16(3):1314-1320. doi: 10.21037/jgo-2025-433

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