Kosin Medical Journal

Brain hemorrhage in patients with advanced hepatocellular carcinoma treated with atezolizumab and bevacizumab: two case reports: Bangju Kim, Hyun Joon Park, Sang Uk Lee, Kwang Il Seo, Jung Wook Lee, Sumin Jo, Jun Yeb Nam; Kosin Med J. 2025;40(2):150-156. Published online June 30, 2025; DOI: https://doi.org/10.7180/kmj.25.114

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Abstract PDF PubReader ePub: A combination of atezolizumab and bevacizumab is currently recommended for treating unresectable advanced-stage hepatocellular carcinoma (HCC), as it has demonstrated superior overall survival and progression-free survival compared to sorafenib. However, concerns have been raised regarding serious adverse events associated with bevacizumab, such as gastrointestinal perforation, fistula, hemorrhage, and arterial thromboembolism. In particular, patients with liver cirrhosis (LC) show an increased risk of variceal bleeding. However, brain hemorrhage associated with the use of bevacizumab in patients with HCC and LC is extremely rare. We encountered two cases of brain hemorrhage in patients with HCC and LC who underwent treatment with atezolizumab and bevacizumab. One patient had no history of hypertension, while the other patient had hypertension that was well-controlled with medication and an unruptured brain aneurysm located on the right side of the anterior communicating artery. Both patients experienced brain hemorrhage after two treatment cycles of atezolizumab with bevacizumab. One patient died due to brain hemorrhage, while the other patient recovered from subarachnoid hemorrhage with successful coil embolization. This case report suggests that if a patient has any high-risk factors associated with brain hemorrhage, physicians should thoroughly consider alternative treatment options for advanced HCC, as brain hemorrhage could be fatal.

The Combination Therapy with Peg-interferon Alfa and Ribavirin for Chronic Hepatitis C in Korea as an Initial Treatment: Dong Hyun Park, Sang Uk Lee, Jin Seok Yu, Jun Seop Lee, Hye Jung Kwon; Kosin Med J. 2012;27(2):111-118. Published online December 27, 2012; DOI: https://doi.org/10.7180/kmj.2012.27.2.111

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Abstract PDF PubReader ePub: Objectives
The combination therapy with peginterferon and ribavirin has been used to treat chronic hepatitis C for several years in Korea but there is a few report about the results of the treatment. We evaluated safety and efficacy of the combination therapy with Peg-interferon and ribavirin and analyzed factors that may affect treatment.
Methods
Total 72 untreated chronic hepatitis C patients were administered pegylated interferon alfa-2a (180µg/week) or alfa-2b (1.5µg/kg/week) and ribavirin (800 mg/day in genotype 2, 1000-1200 mg/day in genotype 1). Duration of the treatment was 24 weeks in genotype 2 and 48 weeks in genotype 1. Response of the treatment was evaluated by rapid virologic response (RVR), early virologic response (EVR), end treatment virologic response (ETR), sustained virologic response (SVR) and adverse event.
Results
The RVR, EVR, ETR, SVR were 61.8%, 82.5%, 88.9% and 80.5% retrospectively. The SVR of genotype 1 was 63.4% and non-genotype 1 was 96.7%. Genotype (Odds ratio: 14.92) was an independent predictor of the SVR. Leukocytopenia, flu-like symptoms, itching, rash and anemia were common adverse events of the combination therapy and if then we reduced dose and there was one case of cessation.
Conclusions
The combination therapy with Peg-interferon and ribavirin shows efficacy to the Korean patients with chronic hepatitis C as an initial treatment. Genotypes 2 and 3 were more likely to have a sustained virologic response.

The Efficacy of Adefovir Dipivoxil in Chronic Hepatitis B with Lamivudine Resistance: Jee Suk Lee, Lee La Jang, Sang Uk Lee, Byung Hoon Han, Byung Chul Yoon; Kosin Med J. 2008;23(2):36-43. Published online June 30, 2008

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The correlation between cyclooxygenase-2 and p53 expression in hepatocellular carcinoma and the effects recurrence after surgery: Byung CHeol Yun, Byung Hoon Han, Sang Uk Lee, Bang Hur; Kosin Med J. 2007;22(1):72-80. Published online June 30, 2007

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Effects of benzo(a)pyrene on the DNA topoisomerase Ⅱ-mediated DNA cleavage in human c-myc protooncogene: In Cheol Jeong, Song Jae Lee, Moo Youn Cho, Sang Uk Lee; The Journal of Kosin Medical College. 1995;10(2):91-95.

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The Study for Clinical Significance of CD34 Expression in Hepatocellular Carcinoma: Ki Bum Kwon, Byung Joo Choe, Jun Chul Pyun, Byung Chul Youn, Sang Uk Lee, Byung Hoon Han; Kosin Med J. 2001;16(1):1-6.

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Natural Killer cell activity and T cell subsets in peripheral blood of hepatocellular carcinoma according to etiology: Jin Wuk Hur, Paul Choi, Hyun Jeung Lim, Su Hong Kim, Eun Seok Kim, Byung Chul Yun, Byung Hun Han, Sang Uk Lee; Kosin Med J. 2003;18(1):36-42.

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Study of HBV and HCV coinfection according to serologic marker in patients with chronic liver disease: Byung Cheol Yun, Byung Hoon Han, Sang Uk Lee; Kosin Med J. 2004;19(1):94-100.

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A Case of Esophageal Perforation Accompanied with Pneumothorax Developed during Endoscopic Retrograde Cholangiogram: Sung In Ha, Sin Kim, Yuri Kim, Chan Bog Park, Jee Hyun Lee, Byung Cheol Yun, Byung Hoon Han, Sang Uk Lee, Dong Hoon Shin; Kosin Med J. 2004;19(1):101-105.

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Expression profile of topoisomerase, ras and myc genes in HL-60 cells treated with camptothecin: In Cheol Jeong, Neung Ju Lee, Sang Uk Lee, Song Jae Lee, Moo Youn Cho; Kosin Med J. 2004;19(1):271-278.

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