ILCA 2023 | Molecular typing based on fatty acid degradation metabolism helps in achieving precision treatment for liver cancer.

ILCA 2023 | Molecular typing based on fatty acid degradation metabolism helps in achieving precision treatment for liver cancer.

2024.02.14
Primary liver cancer is currently the 4th most common malignant tumor and the 2nd leading cause of tumor-related death in China. 75%~85% of these cases are Hepatocellular carcinoma (HCC), posing a serious threat to the health and lives of Chinese citizens. In recent years, with the progress in traditional therapies like surgery, intervention, radiation, targeted therapy, and immunotherapy, there are now more options available for liver cancer patients. Recent clinical studies have shown that the combined treatment plan of atezolizumab and bevacizumab (referred to as “T+A”) can reduce the mortality risk of advanced liver cancer patients by 42% compared to the traditional targeted drug sorafenib, setting a new standard for the first-line treatment of advanced liver cancer. However, the overall survival rate of liver cancer patients remains unsatisfactory, with a 5-year survival rate of about 20%. Due to the heterogeneity of liver cancer, there is still a significant variance in the treatment response and prognosis of patients with the same clinical stage. How to select the most suitable individualized treatment method for different liver cancer patients, to maximize therapeutic effects, is a pressing issue in the clinic.
IMbrave050 trial results: Atezolizumab combined with bevacizumab can significantly improve RFS in patients with HCC at high risk of recurrence

IMbrave050 trial results: Atezolizumab combined with bevacizumab can significantly improve RFS in patients with HCC at high risk of recurrence

2024.01.18
Recent findings from the phase III IMbrave050 trial presented at the 2023 American Association for Cancer Research (AACR) Annual Meeting have unveiled a significant advancement in the treatment of hepatocellular carcinoma (HCC). The trial investigated the impact of adjuvant therapy with atezolizumab in combination with bevacizumab on recurrence-free survival (RFS) in HCC patients at high risk of recurrence following curative resection or ablation. The study's principal investigator, Professor Pierce Chow of the National Cancer Centre Singapore, revealed the trial's results, suggesting a potential paradigm shift in the management of high-risk HCC patients.
ILTS 2023｜Shifting Paradigms in Radiological Assessment of Tumor Load in Liver Transplantation for HCC

ILTS 2023｜Shifting Paradigms in Radiological Assessment of Tumor Load in Liver Transplantation for HCC

2024.01.18
Liver transplantation is a crucial option for treating Hepatocellular Carcinoma (HCC) as it not only removes the tumor but also addresses underlying liver disease. Accurate prediction of post-transplantation outcomes for patients with HCC tumors exceeding MELD standards or awaiting transplantation due to donor shortages is essential to enhance surgical success rates and optimize liver allocation. At the International Liver Transplantation Society (ILTS) Annual Meeting held in Rotterdam, the Netherlands, from May 3rd to 6th, 2023, Dr. Leonardo Centonze from Niguarda Hospital in Milan, Italy, presented a recent clinical study. The study suggests that dynamic grading based on the Liver Imaging Reporting and Data System (LI-RADS) has a significant impact on preoperative outcome prediction. The research indicates that for HCC patients with multiple nodules, every nodule in the liver (not just highly suspicious lesions) should be considered for preoperative evaluation. This will influence the accuracy of liver transplantation outcome prediction.
ILTS 2023 | New Approach for Early Detection of Hepatocellular Carcinoma – Biophysical Characteristics of Tumor Tissue and Serum

ILTS 2023 | New Approach for Early Detection of Hepatocellular Carcinoma – Biophysical Characteristics of Tumor Tissue and Serum

2024.01.18
Biological physics is an interdisciplinary field that combines physics with biology, serving as an important branch of both life sciences and physics. Its aim is to elucidate the laws governing the motion of matter, energy, and information in biological systems within specific spatial and temporal contexts. However, the potential role of biophysical techniques in early cancer screening, particularly for liver cancer, remains a burgeoning research area with limited reports. At the International Liver Transplantation Society (ILTS) Annual Meeting held in Rotterdam, the Netherlands from May 3rd to 6th, 2023, Dr. Subathra Radhakrishnan from the Indian National Liver Foundation presented a study that suggests biophysical analysis may offer new means for non-invasive early diagnosis of Hepatocellular Carcinoma.
ILTS 2023 | Liver Resection or Thermal Ablation as a Bridge to Liver Transplantation for Hepatocellular Carcinoma – DELTAS-HCC Study

ILTS 2023 | Liver Resection or Thermal Ablation as a Bridge to Liver Transplantation for Hepatocellular Carcinoma – DELTAS-HCC Study

2024.01.18
Liver transplantation is one of the curative treatment options for hepatocellular carcinoma (HCC). However, due to the limited availability of liver donors compared to the number of patients awaiting transplantation, only a small number of HCC patients can receive liver transplantation. Previous studies have shown that local treatment before liver transplantation in HCC patients can effectively prevent tumor progression, increase the transplant rate, and reduce the postoperative recurrence rate. Transarterial chemoembolization (TACE) and ablation techniques such as radiofrequency ablation (RFA), microwave ablation, and percutaneous ethanol injection are the most commonly used bridge therapies before liver transplantation. At the International Liver Transplantation Society (ILTS) annual meeting held in Rotterdam, Netherlands, from May 3 to 6, 2023, Dr. Catherine Lamarque and her colleagues from the Henri Mondor Hospital in France reported on a clinical study (DELTAS-HCC) that showed that liver resection or thermal ablation can be effective bridges to liver transplantation for HCC and do not adversely affect patient outcomes before and after transplantation.
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

2024.01.17
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. In 2022, the leading international journal, The Lancet Gastroenterology & Hepatology, published a single-arm Phase II clinical study called START-FIT by Dr. Zhiren Chen's team from the University of Hong Kong, China. This study assessed the efficacy and safety of TACE, SBRT, and PD-L1 inhibitors in treating patients with locally advanced uHCC. At the 13th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2023), the team presented the latest 3-year follow-up data from the START-FIT trial, garnering widespread attention. This report provides a comprehensive overview.
APPLE 2023 | Application of Arterial Therapy in Early Hepatocellular Carcinoma: Korean Experience

APPLE 2023 | Application of Arterial Therapy in Early Hepatocellular Carcinoma: Korean Experience

2024.01.17
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. 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

2024.01.17
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.
Lenvatinib, PD-1 inhibitors combined with radiotherapy safe and effective in treating hepatocellular carcinoma with portal vein tumor thrombus

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

2024.01.17
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.