From July 6th to 8th, 2023, the 13th annual meeting of the Asia-Pacific Primary Liver Cancer Expert Alliance (APPLE) was held in Seoul, South Korea, with the participation of nearly 1000 experts and scholars in the field of liver cancer from around the world.
Hepatocellular carcinoma (HCC) is one of the most common malignancies in China, with most patients diagnosed in the intermediate to advanced stages. The formation of portal vein tumor thrombus (PVTT) is a critical indicator of HCC progression, and patients with HCC combined with PVTT have a very poor prognosis. Previous studies have shown that low-dose radiotherapy can extend the survival of HCC patients with PVTT. From July 6th to 8th, 2023, the 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023) was held in Seoul, South Korea. At the conference, a team led by Academician Jiahong Dong, Dr. Gong Li, and Dr. Keran Li from Beijing Tsinghua Chang Gung Hospital, Tsinghua University, China, presented a clinical study (Abstract Number: PE-97), investigating whether PVTT is more sensitive to radiotherapy than the primary tumor and exploring the efficacy of downstaging treatment in HCC patients with PVTT through the combination of radiotherapy, anti-angiogenic medication, and immunotherapy. Hepatology Digest had the privilege of inviting Dr. Gong Li to share the results of this research and its clinical application prospects.
The World Health Organization (WHO) has set ambitious goals in its Action Plan for the Elimination of Viral Hepatitis: by 2030, the diagnosis rate for chronic hepatitis B (CHB) should reach 90%, the treatment rate for eligible patients should be 80%, new infections should decrease by 90%, and related deaths should decrease by 65%. However, recent data shows that in mainland China and Hong Kong, the diagnosis rates for CHB are only 19% and 27%, respectively, and the treatment rates are only 11% and 22%, respectively. Globally, the diagnosis and treatment rates for CHB are only 10% and 5%, respectively. Achieving WHO's 2030 goal of eliminating viral hepatitis as a public health threat remains a daunting challenge. At the 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023), Dr. Wai-Kay Seto from the University of Hong Kong, China, was invited to give a special report on the risks and benefits of long-term HBV treatment.
In recent years, there has been rapid progress in the systemic treatment of liver cancer, with new immunotherapies and targeted therapies continually emerging. This has also driven ongoing innovation in the concepts and approaches for treating HCC. From July 6th to 8th, 2023, the 13th Asia-Pacific Primary Liver Cancer Experts Conference (APPLE 2023) was held in Seoul, South Korea. During the conference, one of the founders of APPLE, Dr. Masatoshi Kudo from Kindai University in Japan, shared the latest research developments in systemic treatment for intermediate HCC and its potential applications. Hepatology Digest had the privilege of conducting an in-depth interview with Dr. Kudo at the APPLE conference. Here, we present the contents of that interview for our readers.
The diagnosis of liver cancer involves three aspects, including imaging, blood test results, and biopsy pathology results. Typically, the diagnosis of a tumor is confirmed only under a microscope after obtaining pathological tissue. However, liver cancer has its unique characteristics, and its diagnosis can be based on cirrhosis and confirmed through imaging tests such as computer tomography scans and magnetic resonance imaging. At the recently concluded 13th Asia-Pacific Primary Liver Cancer Expert Conference (APPLE 2023), Dr. Kathryn J. Fowler from the University of California, San Diego, shared insights from the perspective of a radiologist on the effectiveness and reliability of liver cancer imaging in clinical diagnosis, as well as the positive role of imaging in the classification and prognosis prediction of liver cancer patients. Hepatology Digest had the privilege of conducting an in-depth interview with Dr. Fowler at the conference, and we have compiled the content for our readers.
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.
Liver cancer has become the 6th most common and the 3rd leading cause of cancer deaths worldwide. For liver cancer patients, surgery is the preferred method to completely eliminate tumors and achieve long-term survival. However, the majority of liver cancer patients still face late diagnoses and low survival rates. In recent years, the systemic treatment of liver cancer has progressed rapidly, with new immunotherapies and targeted drugs emerging, promoting continuous innovation in liver cancer treatment concepts and schemes. From July 6-8, 2023, the 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023) was grandly held in Seoul, South Korea. At the conference, Dr. Hanchong Toh from the National Cancer Centre Singapore shared the latest developments in immune adjuvant therapy for liver cancer.
Liver cancer is the third leading cause of cancer death in China. In recent years, the application of targeted and immunotherapies has improved the survival of liver cancer patients. However, due to the high molecular heterogeneity of liver cancer, there is still a lack of biological markers for predicting clinical efficacy, and there is a significant difference in treatment responses among liver cancer patients. From July 6th to 8th, 2023, the 13th Asia-Pacific Primary Liver Cancer Experts Conference (APPLE 2023) was grandly held in Seoul, South Korea. At the conference, Dr. Irene Oi-Lin Ng from the University of Hong Kong, China, shared recent advancements in the study of liver cancer's molecular heterogeneity and its biological markers, offering new insights into the development of novel clinical treatment strategies and precise drug efficacy predictions for personalized precision diagnosis and treatment. Hepatology Digest had an in-depth interview with Dr. Ng at the APPLE conference.
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.
Early-stage liver cancer can be cured with radical surgery. However, tumor recurrence remains the primary challenge affecting patients' long-term survival. Currently, the five-year recurrence rate for early-stage liver cancer post-surgery is about 60%. Addressing this challenge and improving long-term survival for these patients is a pressing clinical issue. From July 6th to 8th, 2023, the 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023) was held grandly in Seoul, South Korea. A special session on "Unmet Clinical Needs and Research Directions" was set up, inviting several internationally renowned liver cancer scholars for an in-depth discussion. During this, Dr. Linda Wong from the University of Hawaii shared her insights on the promising vision of adjuvant therapies, such as systemic therapy and TACE, for the cure of early-stage liver cancer.
