10肝癌发展

StephenW

10 developments in liver cancer
October 5, 2016



Discovering links between hepatocellular carcinoma and direct-acting antivirals, exploring risk factors for HCC, conducting clinical trials of new medications for the disease — these are just some of the ways researchers are working towards finding a cure for liver cancer. Hepatocellular carcinoma — according to one report — will take 27,000 lives this year and another 40,000 cases will be diagnosed. Earlier this year, the Annual Report to the Nation on the Status of Cancer reported deaths by hepatocellular carcinoma held the highest rate of all common cancers between 2003 and 2012.

In recognition of October being Liver Cancer Awareness Month, Healio.com/Hepatology highlights 10 of the most popular articles regarding HCC over the past year.

1. Nearly one-third of patients with previous HCC recur after DAA therapy

BARCELONA — Though hepatocellular carcinoma after direct-acting antiviral therapy rarely occurs, patients with a history of HCC recurred at a rate of 29%, according to a presenter at the International Liver Congress.

Laurent Caster

“The facts are that we currently have two independent studies from two different countries showing similar results that these high rate, early recurrence of HCC in patients treated with DAA with previous HCC. This is unexpected. We suspect that it is a disruption of immune surveillance because this has not been seen with the previous treatment” Laurent Castera, MD, PhD, and EASL secretary-general, told Healio.com/Hepatology. Read more

2. First patient treated in phase 3 trial for HCC medication Pexa-Vec

Researchers at the University of Tennessee Medical Center have treated the first patient in the phase 3 clinical trial for the hepatocellular carcinoma medication Pexa-Vec, according to a press release.

“We are at the forefront of bringing innovative cancer treatment to patients,” Laura Findeiss, MD, professor and chair of the department of radiology at the University of Tennessee Medical Center and UT Graduate School of Medicine, said in the release. “I remain excited about the potential this new cancer immunotherapy holds.” Read more

3. SILIUS: Nexavar plus chemotherapy fails to improve overall survival in HCC

BARCELONA —  Nexavar plus a chemotherapy regimen was not superior to Nexavar alone in improving overall survival in a cohort of patients with hepatocellular carcinoma, according to findings presented at the International Liver Congress.

However, Masatoshi Kudo, MD, of Kinki University Hospital in Osaka-Sayama, Japan, noted that OS was significantly better in patients who responded to either sorafenib or combination therapy than in non-responders. Read more

4. Undetected cirrhosis common at HCC diagnosis

In a U.S. Veteran population, a majority of patients with hepatocellular carcinoma had undetected cirrhosis at the time carcinoma was diagnosed. These patients were also more likely to have advanced stage HCC, according to research published in Alimentary Pharmacology and Therapeutics.

“The failure to recognize cirrhosis was strongly associated with advanced stage at the time of HCC diagnosis,” the researchers wrote. Read more

5. Stivarga increases OS in patients with unresectable HCC

Bayer announced results of its phase 3 RESORCE clinical trial, indicating Stivarga improved overall survival in patients with unresectable hepatocellular carcinoma.

The safety and tolerability of the drug were consistent with the known profile of regorafenib, according to a press release. Read more

6. Diabetes, metabolic syndrome increase risk for HCC

HONOLULU — Researchers from Penn State Milton S. Hershey Medical Center found that diabetes and metabolic syndrome were independent risk factors for the development of hepatocellular carcinoma, according to data presented during a plenary session at ACG 2015.

Among patients with diabetes, metformin and cholesterol medications were significantly protective against HCC, while insulin represented an increased risk of developing HCC when compared to diabetes alone. Sulfonylureas had no significant effect on HCC risk. Read more

7. OS comparable between Dovitinib, Nexavar for advanced HCC

The overall survival and safety rates were similar between patients with advanced hepatocellular carcinoma treated with Dovitinib vs. Nexavar, according to published findings.

“Although sorafenib has shown to improve overall survival and radiological time-to-tumor progression in Asian-Pacific patients with advanced HCC (median OS, 6.5 months; median time to tumor progression, 2.8 months), better systemic therapy remains an unmet need for patients with HCC in the Asia-Pacific region,” Ann-Lii Cheng, MD, PhD, of the National Taiwan University Hospital and National Taiwan University Cancer Center, and colleagues wrote. Read more

8. Nintedanib shows promise for treatment of HCC

Nintedanib, a triple angiokinase inhibitor, was found to be safe for treating patients with hepatocellular carcinoma and mild or moderate liver impairment, according to data from a phase 1 trial presented at the European Society for Medical Oncology’s European Cancer Congress.

Masafumi Ikeda

“The [adverse events] profile of nintedanib was similar in patients previously treated with sorafenib,” Masafumi Ikeda, MD, chief of the department of hepatobiliary and pancreatic oncology, National Cancer Center Hospital East, Kashiwa, Japan, and researchers wrote. Read more

9. US veterans have increased frequency of HCC at autopsy

United States military veterans had an increased frequency of hepatocellular carcinoma at autopsy compared with the general population, according to findings published in Clinical Gastroenterology and Hepatology.

Aqsa Nasir, MD
Aqsa Nasir

“Significant risk factors identified were chronic hepatitis C and liver cirrhosis,” Aqsa Nasir, MD, in the department of pathology and laboratory medicine at the University of Minnesota School of Medicine, told Healio.com/Hepatology. Read more

10. Baraclude therapy for HBV leads to lower than expected HCC incidence

Patients with hepatitis B virus infection treated with Baraclude had an unexpected lower incidence of hepatocellular carcinoma over time, although the risk for hepatocellular carcinoma in this patient population still persisted, according to the results of a retrospective study.

Joseph Ahn

“In this ‘real-world’ study of a large number of U.S. patients, treatment with [entecavir] was associated with a 64% lower observed than expected HCC incidence in [patients with chronic hepatitis B] without cirrhosis,” Joseph Ahn, MD, MS, AGAF, FACG, of the division of gastroenterology and hepatology, Oregon Health and Science University, and colleagues wrote. Read more

StephenW

2016年10月5日

10肝癌发展肝癌

发现肝癌和直接作用的抗病毒药物之间的联系，探索危险因素HCC，开展为疾病新药的临床试验 - 这些都只是一些研究人员正在往发现肝癌治愈的工作方式。根据一份报告 - - 肝癌将于27000生活今年的4万人案例将进行诊断。今年早些时候，在癌症地位的国家年度报告报告的死亡肝细胞癌举行的2003和2012年之间的所有常见的癌症率最高。

在认识到十月是肝癌防治月，Healio.com/Hepatology突出肝癌方面在过去的一年中最流行的文章10。

患者以前HCC 1.近三分之一DAA治疗后复发

巴塞罗纳 - 虽然后直接作用的抗病毒治疗肝癌很少发生，肝癌患者的复发史在29％的速度递增，根据在国际肝病会议演示。

洛朗脚轮

“事实是，我们目前有来自两个不同的国家显示了类似的结果两个独立的研究，这些高利率，在与早期肝癌DAA治疗的患者肝癌早期复发。这是意想不到的。我们怀疑这是免疫监视的破坏，因为这并没有被看到与以前的待遇“洛朗Castera博士和EASL秘书长告诉Healio.com/Hepatology。阅读更多

2.首先患者3期试验治疗肝癌药物Pexa-VEC

田纳西州医学中心大学的研究人员在3期临床试验的肝癌药物Pexa-VEC治疗的第一个病人，根据新闻稿。

“我们是在把创新癌症治疗给患者的前沿，”劳拉Findeiss，医学博士，教授，放射科在田纳西医学中心和医学UT研究生院的大学的系主任，在新闻稿中说。 “我仍然高兴这个新的癌症免疫疗法持有的潜力。”阅读全文

3.西柳斯：多吉美联合化疗不能改善肝癌总生存率

巴塞罗纳 - 多吉美加化疗方案并不优于单独多吉美在提高总生存期的肝癌患者队列，根据在国际肝病大会上提出的调查结果。

然而，工藤正俊，MD，近畿大学医院在大阪狭山，日本的指出，OS是谁回答索拉非尼治疗或联合治疗较无应答患者显著更好。阅读更多

4.肝硬化未被发现在肝癌诊断常见

在美国退伍军人的人口，大部分的肝癌患者有肝硬化未被发现当时癌被确诊。这些患者也更可能有晚期肝癌，根据发表在消化道药理学和治疗学研究。

“认识到肝硬化的故障是在强烈的肝癌诊断时与高级阶段有关，”研究人员写道。阅读更多

5. Stivarga增加OS患者的肝癌患者

拜耳宣布了其第3阶段RESORCE临床试验结果，显示在Stivarga患者不能手术切除的肝细胞癌总体生存率改善。

安全性和药物耐受性均与regorafenib的已知轮廓一致，根据新闻稿。阅读更多

6.糖尿病，代谢综合征的风险增加肝癌

檀香山 - 研究人员从宾夕法尼亚州立大学的米尔顿·好时学医学中心发现，糖尿病和代谢综合征是肝癌的独立危险因素，根据在ACG 2015年全体会议期间提出的数据。

之间的糖尿病患者，二甲双胍和胆固醇的药物反对肝癌显著保护，单独相比糖尿病时，而胰岛素表示显影HCC的风险增加。磺脲类药物对肝癌的风险无显著影响。阅读更多

7. OS Dovitinib，多吉美的晚期肝癌之间的可比性

总生存和安全性分别为患者与Dovitinib与多吉美治疗晚期肝癌相似，根据公布的调查结果。

“尽管索拉非尼已经显示出改善亚洲太平洋肝炎患者与晚期肝癌总生存率和放射学时间到肿瘤进展（中位OS 6.5个月;中位肿瘤进展时间2.8个月），更好的全身治疗仍然是一个未满足的需要肝癌患者在亚太平洋C区，“安 - 吕澄博士，国立台湾大学医院和国立台湾大学癌症中心，和同事写道。阅读更多

8. Nintedanib显示了治疗肝癌的承诺

Nintedanib，三angiokinase抑制剂，被认为是治疗肝癌患者与轻度或中度肝功能损害安全，根据从欧洲社会提出了肿瘤医学的欧洲癌症大会第一阶段试验的数据。

池田雅史

“nintedanib的[不良反应]个人资料是类似的患者以前用索拉非尼治疗，”师Masafumi池田博士，肝胆胰肿瘤科主任，美国国家癌症中心医院东柏，日本和研究人员写道。阅读更多

9.美国退伍军人尸检增加肝癌的频率

美国退伍军人有肝癌尸检频率增加与普通人群相比，根据发表在临床胃肠病学和肝病的研究结果。

阿克萨纳西尔，MD
阿克萨纳西尔

“查明的重大危险因素为慢性丙型肝炎和肝硬化，”阿克萨纳西尔，医学博士，病理学和实验医学杂志在明尼苏达大学医学院的部负责人告诉Healio.com/Hepatology。阅读更多

10.博路定治疗HBV导致比预期的HCC发生率较低

患者与治疗的博路定乙肝病毒感染过一段时间肝癌的意外发生率较低，虽然在这个患者人群为肝癌的风险仍然存在，根据一项回顾性研究的结果。

约瑟夫·安

“在众多的美国患者的这种”真实世界“研究中，用64％，比[例慢性乙型肝炎]预计HCC发生率无肝硬化下观察到的，有关[恩替卡韦]待遇”约瑟夫·安，MD ，MS，AGAF，FACG，学和免疫分工，俄勒冈健康与科学大学，和同事写道。阅读更多