Liver cancer risks, detection: 8 recent reports
July 16, 2018
Patients with liver disease such as viral hepatitis and nonalcoholic fatty liver disease with cirrhosis are at increased risk for progression to hepatocellular carcinoma, which can also lead to extrahepatic cancer. Researchers have recently published new data on factors that improve early detection and diagnosis, as well as defining risks prior to HCC and during treatment.
Healio presents the following recent reports that include studies on ethnic differences in liver cancer detection, improved diagnosis with bi-annual screening, and innovative noninvasive testing solutions.
Ethnic differences determine liver cancer detection, outcomes
Researchers determined racial and ethnic differences that correlated with early detection of hepatocellular carcinoma and receipt of curative treatment, which could be used as intervention targets to improve patient outcomes.
“As with most malignancies, HCC tumor burden at diagnosis impacts both prognosis and treatment decisions,” Nicole E. Rich, MD, from the University of Texas Southwestern Medical Center, and colleagues wrote. “Understanding and quantifying potential differences is the first step to identify intervention targets and inform strategies to reduce existing disparities. Read more
Bi-annual liver cancer screening for cirrhosis improves diagnosis, survival
Compliance with hepatocellular carcinoma surveillance correlated with early diagnosis, better allocation of curative treatment and longer overall survival among patients with hepatitis C- or hepatitis B-associated compensated cirrhosis, according to a recently published study.
“Monitoring for HCC in patients with cirrhosis, based on bi-annual ultrasound examination is recommended by international guidelines,” Charlotte Costentin, MD, from the Hôpital Henri Mondor in France, and colleagues wrote. “Improving compliance with surveillance guidelines should translate into a significant improvement in the prognosis of this deadly cancer.” Read more
Pediatric liver cancer may lead to brain metastases
Fibrolamellar hepatocellular carcinoma, a rare childhood liver cancer, metastasized to the brain, prompting researchers to recommend surveillance neuroimaging for patients with advanced disease, according to published findings.
“Current treatment for fibrolamellar hepatocellular carcinoma focuses on gross total resection, as systemic therapy remains unstandardized,” Sanford M. Simon, PhD, professor at the Laboratory of Cellular Biophysics at The Rockefeller University, and colleagues wrote. “However, fibrolamellar hepatocellular carcinoma is frequently diagnosed at an advanced stage, and the majority relapse within 1 year despite resection. ... Reports of two patients with brain metastasis exist in the literature but neither provides neuroimaging, pathologic or molecular analysis of the lesions.”
Plasma assay of methylated DNA markers detects liver cancer
In this exclusive video perspective from Digestive Disease Week 2018, John B. Kisiel, MD, a gastroenterologist from the Mayo Clinic in Rochester, Minn., shares results of a study in which plasma assay of methylated DNA markers detected hepatocellular carcinoma across all stages.
“These are markers we discovered as part of a larger set in an experiment that sequenced DNA extracted from frozen tissue specimens from patients at Mayo Clinic,” Kisiel told Healio Gastroenterology and Liver Disease. “The aim of the present study was to validate these markers in a larger cohort that included a spectrum of stages of disease, including early-stage patients who would be potentially curable.” Watch here
Exact Sciences expands noninvasive cancer testing in the GI space
In this exclusive industry perspective from Digestive Disease Week 2018, Kevin Conroy, CEO of Exact Sciences, discusses the company’s noninvasive Cologuard colon cancer test and recent data on a new noninvasive test for the detection of liver cancer.
“Exact Sciences’ mission is to help play a role in the eradication of colon cancer,” Conroy told Healio Gastroenterology and Liver Disease. “We developed Cologuard, which is a noninvasive stool DNA test that is the first and only stool DNA test approved by the FDA. It’s been used to screen over 1.1 million people in the U.S., and over 110,000 physicians use Cologuard.” Watch here
Stivarga improves HCC outcomes in cases of progression during Nexavar therapy
Stivarga therapy provided clinical benefit to patients with hepatocellular carcinoma and had similar adverse event rates regardless of the last Nexavar dose or time-to-progression on prior Nexavar therapy, according to a recently published study.
Richard S. Finn, MD, from the David Geffen School of Medicine at the University of California Los Angeles, and colleagues conducted a retrospective analysis of the RESOURCE trial — the results of which showed Stivarga (regorafenib, Bayer) significantly improved overall survival in patients whose HCC progressed during Nexavar (sorafenib, Bayer) therapy — to verify the outcomes of sequential treatment with sorafenib followed by regorafenib. Read more
Abstinence does not reduce HCC risk in alcoholic-related cirrhosis
Alcohol abstinence did not reduce the risk for hepatocellular carcinoma among patients with Child-Pugh class A or B alcohol-related cirrhosis, according to a presentation at the International Liver Congress 2018.
“Our goal was to investigate if abstinence reduces HCC risk in a series of patients with alcoholic liver cirrhosis who were included in an HCC surveillance program,” Andrés Castano-Garcia, MD, PhD, from the Hospital Universitario Central de Asturias in Spain, said in his presentation. “Abstinence was defined as the absence of any alcohol consumption from inclusion and established based on interviews with patients.” Read more
Novel score predicts liver cancer risk during HBV antiviral therapy
Researchers developed a predictive risk score for the development hepatocellular carcinoma during oral antiviral therapy in patients with chronic hepatitis B, according to recently published data.
“The score requires simple information that is readily available in all treated patients,” Yao-Chun Hsu, MD, from the Fu-Jen Catholic University, Taiwan, and colleagues wrote. “By stratifying patients at different risks of HCC, the easily applicable score may inform the clinical practice and healthcare policy in the era of antiviral treatment for [chronic HBV].” Read more
洛克菲勒大学细胞生物物理实验室教授Sanford M. Simon博士及其同事写道：“目前对纤维板层肝细胞癌的治疗主要集中在全切除术上，因为全身治疗仍未得到标准化。” “然而，纤维板层肝细胞癌经常被诊断为晚期，并且尽管切除，大多数在1年内复发。 ...有两例脑转移患者的报告存在于文献中，但都没有提供病变的神经影像学，病理学或分子学分析。“阅读更多
甲基化DNA标记物的血浆测定检测肝癌
在2018年消化疾病周的独家视频视角中，来自明尼苏达州罗切斯特市梅奥诊所的胃肠病学家John B. Kisiel博士分享了一项研究结果，其中甲基化DNA标记物的血浆检测检测到所有阶段的肝细胞癌。
“这些是我们在Mayo Clinic患者的冷冻组织标本中提取DNA的实验中发现的较大组的一部分，”Kisiel告诉Healio Gastroenterology and Liver Disease。 “本研究的目的是在更大的队列中验证这些标志物，其中包括一系列疾病阶段，包括可能治愈的早期患者。”在这里观察