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JAMA Oncology Clinical Challenge
August 29, 2019

Weakness and Myalgia in a Patient With Hepatocellular Carcinoma Undergoing Checkpoint Inhibitor Therapy

Author Affiliations
  • 1Johns Hopkins School of Medicine, Baltimore, Maryland
  • 2The Johns Hopkins Hospital, Baltimore, Maryland
  • 3Johns Hopkins University, Baltimore, Maryland
JAMA Oncol. Published online August 29, 2019. doi:10.1001/jamaoncol.2019.2304

A 59-year-old man with nonalcoholic steatohepatitis was found to have a 12.4-cm liver mass, with imaging characteristics concerning for malignant neoplasm (Figure, A). A biopsy was performed, and pathology results were consistent with a well-differentiated hepatocellular carcinoma. He enrolled in a phase 1 clinical trial (NCT03299946) using neoadjuvant cabozantinib plus nivolumab followed by definitive resection for patients with locally advanced disease.