International Hepatology

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. Most patients are diagnosed at intermediate or advanced stages. The formation of portal vein tumor thrombus (PVTT) is a significant indicator of advanced HCC, with over half of late-stage HCC patients presenting with PVTT. Especially VP4 type (main portal vein), these patients usually have a poor prognosis. Most phase III clinical trials have excluded these patients. Lenvatinib is a new multi-targeted small molecule inhibitor now approved for advanced HCC. In Asian populations, Lenvatinib combined with a PD-1 inhibitor has shown good antitumor activity and safety. Radiotherapy has also brought about positive outcomes for HCC patients with PVTT. The 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023) was held in Seoul, Korea, from July 6-8, 2023. At the conference, the team from the affiliated Beijing Tsinghua Chang Gung Hospital, Tsinghua University, China, reported on a clinical study (Abstract Number: PE-117), exploring the preliminary efficacy and safety of Lenvatinib combined with a PD-1 inhibitor and radiotherapy in HCC patients with main portal vein tumor thrombus. Hepatology Digest invited Dr. Guangxin Li to share insights on the study and its clinical prospects.

Hepatocellular carcinoma (HCC) is the most common malignant liver tumor in our country, posing a significant threat to the lives and health of our people. Presently, the treatment for advanced HCC is primarily systemic therapy based on targeted and immunotherapy. Deciding on the appropriate multi-target inhibitors and immunotherapies for combined treatment is a hot topic in current research. At the recently concluded 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023), researchers from the Hong Kong Polytechnic University, China, presented a study (Abstract Number: OP-07) that reveals the mechanism of the wild-type Kras gene in HCC immune evasion. This research suggests that combining KRAS inhibitors might enhance the immunotherapeutic response in liver cancer patients, earning it the honor of an outstanding oral report. We have compiled and edited the findings of this study for our readers.

Stereotactic Body Radiotherapy (SBRT), as a novel radiotherapy technique, has achieved encouraging results in the treatment of liver cancer. It not only improves local tumor control but also reduces distant metastases caused by tumors. Additionally, it minimizes radiation therapy-related complications, enhancing the quality of life for patients after treatment. However, how to maximize the role of SBRT in comprehensive liver cancer treatment is a topic worthy of further exploration. At the 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023), Dr. Zhaochong Zeng and his team from Zhongshan Hospital, Fudan University, China, presented two studies selected for oral and poster presentations, focusing on improving the effectiveness of SBRT and reducing radiation therapy-related adverse reactions, which attracted significant attention at the conference. In this article, Dr. Zeng shares insights into these two studies.