APPLE 2023 | Combining KRAS inhibitors may enhance immunotherapeutic response in liver cancer patients

APPLE 2023 | Combining KRAS inhibitors may enhance immunotherapeutic response in liver cancer patients

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.
Dr. Hanchong Toh: Promising Prospects for Immune Adjuvant Therapy in Liver Cancer

Dr. Hanchong Toh: Promising Prospects for Immune Adjuvant Therapy in Liver Cancer

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.
Dr. Oi-Lin Ng: Heterogeneity of Liver Cancer and its Biological Markers

Dr. Oi-Lin Ng: Heterogeneity of Liver Cancer and its Biological Markers

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.
APPLE 2023 | Lenvatinib, PD-1 inhibitors combined with radiotherapy safe and effective in treating hepatocellular carcinoma with portal vein tumor thrombus

APPLE 2023 | Lenvatinib, PD-1 inhibitors combined with radiotherapy safe and effective in treating hepatocellular carcinoma with portal vein tumor thrombus

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.
Dr. Linda Wong: Adjuvant Therapy Could Usher in a New Paradigm for Early-Stage Liver Cancer Treatment

Dr. Linda Wong: Adjuvant Therapy Could Usher in a New Paradigm for Early-Stage Liver Cancer Treatment

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.
APPLE2023 | Application of Arterial Therapy in Early Hepatocellular Carcinoma: Korean Experience

APPLE2023 | Application of Arterial Therapy in Early Hepatocellular Carcinoma: Korean Experience

With the advancement and innovation in surgical techniques, interventions, radiofrequency ablation, and other treatment methods, there are increasing treatments for early hepatocellular carcinoma. Curative treatments, including liver resection, liver transplantation, interventional treatment, ablative treatment, and radiotherapy, have all achieved satisfactory results. However, how to effectively and minimally invasively treat early hepatocellular carcinoma and manage it in the long term, while ensuring patients achieve long-term survival and improving their quality of life, has been widely discussed in recent years. From July 6-8, 2023, the 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023) was held in Seoul, South Korea. A special session on the evolving management of early HCC was set up. Notably, Dr. Hyo-Cheol Kim from Seoul University, introduced the application of arterial therapy in early hepatocellular carcinoma and shared experiences from Korean hospitals.
Dr. Zhiren Chen: 3-year follow-up data from the START-FIT trial, showing an ORR of 67% for local advanced liver cancer patients

Dr. Zhiren Chen: 3-year follow-up data from the START-FIT trial, showing an ORR of 67% for local advanced liver cancer patients

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. In recent years, with the continuous improvement of diagnosis and treatment, the misdiagnosis rate and mortality of early-stage HCC have greatly decreased. However, many patients are already at an advanced stage when liver cancer is detected, making curative treatment impossible. For these inoperable HCC (uHCC) patients, how to maximize the rescue of the patient's life remains a major challenge. The emergence of local treatments, targeted therapies, immunotherapies, and multidimensional combined treatments has promoted the transition of uHCC patients to earlier stages, enhancing their survival benefits.
How to choose the maintenance treatment plan after HSCT for R/R malignanthematological patients?

How to choose the maintenance treatment plan after HSCT for R/R malignanthematological patients?

Relapse/refractory (R/R) has always been a difficult point in the clinical treatment of malignant hematological tumors. Hematopoietic stem cell transplantation (HSCT) is an important treatment for these patients to achieve long-term survival. Subsequent maintenance treatment is essential to consolidate the effects of HSCT and prevent disease recurrence. Therefore, researchers have been focusing on optimizing the specific maintenance treatment plan for a long time.
Dr. Xingyu Cao: Post-transplant maintenance therapy with Chidamide in T-ALL patients is expected to reduce relapse and improve survival

Dr. Xingyu Cao: Post-transplant maintenance therapy with Chidamide in T-ALL patients is expected to reduce relapse and improve survival

Acute T-cell lymphoblastic leukemia (T-ALL) is a highly heterogeneous malignant tumor of the hematopoietic system caused by the malignant transformation of T-cell precursors. It has significant differences from B-cell precursor acute lymphoblastic leukemia (BCP-ALL) in clinical features, cellular genetics, molecular biology, and abnormal signal transduction pathways. T-ALL accounts for 10%-15% in children and 20%-25% in adults. Adult T-ALL has a poor prognosis due to primary chemotherapy resistance and early recurrence, with a 5-year event-free survival rate of only 20%-50%. The main challenge for T-ALL patients after transplantation is recurrence. From April 23-26, 2023, the EBMT Annual Meeting was grandly held in Paris, France. At the meeting, Dr. Cao Xingyu from Hebei Yanda Ludao Pei Hospital reported a clinical study (abstract number: 351), which suggested that the use of Chidamide for maintenance treatment might improve the survival of T-ALL patients after allogeneic hematopoietic stem cell transplantation (Allo-HSCT).
Dr.  Hui Wang: Unlocking a New Approach to MRD Testing in Acute Myeloid Leukemia

Dr.  Hui Wang: Unlocking a New Approach to MRD Testing in Acute Myeloid Leukemia

The 49th European Bone Marrow Transplantation Annual Meeting (EBMT 2023) took place in Paris, France, from April 23 to 26, 2023. Experts and scholars from various countries gathered to present exciting advancements in research. In the field of blood tests, the fifty-year anniversary of flow cytometry coincided with this year's conference. Over the past half-century, this technology has become an indispensable tool in the diagnosis and follow-up of hematological malignancies. Acute Myeloid Leukemia (AML) is the most common acute leukemia in adults, and the detection of Minimal Residual Disease (MRD) plays a crucial role in clinical treatment and prognosis assessment, despite encountering various technical challenges. With the release of two significant expert consensus statements by the European Leukemia Network (ELN) in 2018 and 2021, technical issues related to AML MRD detection by Multiparameter Flow Cytometry (MFC) were discussed, making this research once again the focus of the hematology field.