Key Clinical Message: In younger patients, including those with extensive infarction involving the anterior and middle cerebral artery regions of the right hemisphere, appropriate treatment for rare causes and goal-oriented long-term rehabilitation could improve severe hemiplegia and higher brain dysfunction, and allow for further education and employment.
Abstract: Although the number of young stroke patients is small, many have serious sequelae and rare causes. In addition to independence in activities of daily living, education and employment are desired.
Background: Lenvatinib was expected to enhance the effect of immune checkpoint inhibitors (ICIs) for unresectable HCC; however, their combination therapy failed to show the synergy in the phase III clinical trial.
Methods: To elucidate lenvatinib-induced molecular modulation, we performed bulk RNA-sequencing and digital spatial profiling of 5 surgically resected human HCC specimens after lenvatinib treatment and 10 matched controls without any preceding therapy.
Findings: Besides its direct antitumor effects, lenvatinib recruited cytotoxic GZMK+CD8 T cells in intratumor stroma by CXCL9 from tumor-associated macrophages, suggesting that lenvatinib-treated HCC is in the so-called excluded condition that can diminish ICI efficacy.