Reviewer ’s report  
 
Title:  Exceptional serological and radiological response to sorafenib in 2 patients with advanced 
hepatocellular carcinoma and chronic hepatitis C viral infection: Case report and review of the 
literature.  
 
Version: 0 Date: 02 Nov 2016 
 
Reviewer:  Avik  Majumdar  
 
Reviewer’s report:  
 
Atkin and co lleagues describe two cases of advanced hepatocellular carcinoma who have had 
remarkable reponses to sorafenib therapy.  Case reports have previously identified similar 
responses, although these are rare and seen mostly in HCV -related HCC.  This is a well written 
and interesting case report with a good discussion. I have a few general and minor specific 
comments:  
 
 
General Comments  
 
- The performance status of both patients should be mentioned  
 
- The choice for TACE as first -line therapy should be briefly expl ained for Case 1 as the 
patient has portal vein invasion.  TACE has been used with good results in very selected patients 
with portal vein invasion, however the decision on its use varies from centre to centre  
 
- During the initial post TACE period of tumou r progression in Case 1, did the portal vein 
invasion extend?  
 
- Did case 1 have any post -mortem histology available?  If so, were any genetic studies 
carried out?  
 
 
Specific Comments  
 
Page 4  
 
- line 40: please provide reference for 2 cases  
 
Page 5  
 
- line 41: ref 14 only needs to be at the end of this paragraph  
 
- Line 53: suggest adding comma "In vitro, sorafenib,…"  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in yo ur comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in t he future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will b e posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title:  Exceptional serological and radiological response to sorafenib in 2 patients with advanced 
hepatocellular carcinoma and chronic hepatitis C viral infection: Case report and review of the 
literature.  
 
Version: 0 Date: 02 Nov 2016 
 
Reviewer:  Avik  Majumdar  
 
Reviewer’s report:  
 
Atkin and co lleagues describe two cases of advanced hepatocellular carcinoma who have had 
remarkable reponses to sorafenib therapy.  Case reports have previously identified similar 
responses, although these are rare and seen mostly in HCV -related HCC.  This is a well written 
and interesting case report with a good discussion. I have a few general and minor specific 
comments:  
 
 
General Comments  
 
- The performance status of both patients should be mentioned  
 
- The choice for TACE as first -line therapy should be briefly expl ained for Case 1 as the 
patient has portal vein invasion.  TACE has been used with good results in very selected patients 
with portal vein invasion, however the decision on its use varies from centre to centre  
 
- During the initial post TACE period of tumou r progression in Case 1, did the portal vein 
invasion extend?  
 
- Did case 1 have any post -mortem histology available?  If so, were any genetic studies 
carried out?  
 
 
Specific Comments  
 
Page 4  
 
- line 40: please provide reference for 2 cases  
 
Page 5  
 
- line 41: ref 14 only needs to be at the end of this paragraph  
 
- Line 53: suggest adding comma "In vitro, sorafenib,…"  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in yo ur comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in t he future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will b e posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title:  Exceptional serological and radiological response to sorafenib in 2 patients with advanced 
hepatocellular carcinoma and chronic hepatitis C viral infection: Case report and review of the 
literature.  
 
Version: 0 Date: 02 Nov 2016 
 
Reviewer:  Avik  Majumdar  
 
Reviewer’s report:  
 
Atkin and co lleagues describe two cases of advanced hepatocellular carcinoma who have had 
remarkable reponses to sorafenib therapy.  Case reports have previously identified similar 
responses, although these are rare and seen mostly in HCV -related HCC.  This is a well written 
and interesting case report with a good discussion. I have a few general and minor specific 
comments:  
 
 
General Comments  
 
- The performance status of both patients should be mentioned  
 
- The choice for TACE as first -line therapy should be briefly expl ained for Case 1 as the 
patient has portal vein invasion.  TACE has been used with good results in very selected patients 
with portal vein invasion, however the decision on its use varies from centre to centre  
 
- During the initial post TACE period of tumou r progression in Case 1, did the portal vein 
invasion extend?  
 
- Did case 1 have any post -mortem histology available?  If so, were any genetic studies 
carried out?  
 
 
Specific Comments  
 
Page 4  
 
- line 40: please provide reference for 2 cases  
 
Page 5  
 
- line 41: ref 14 only needs to be at the end of this paragraph  
 
- Line 53: suggest adding comma "In vitro, sorafenib,…"  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in yo ur comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in t he future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will b e posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review policy of the journal  
assistant