2019 Liver Cancer News
Scientists Discover Potential Drug Compounds That Target Common Type Of Liver Cancer
Four potential drug compounds that target Hepatocellular Carcinoma (HCC) have been discovered by scientists from the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore, and the Agency for Science, Technology and Research (A*STAR)'s Genome Institute of Singapore (GIS). The research team developed a cancer gene-targeting drug-screening platform to identify potential drug candidates against SALL4, a cancer gene linked to HCC. According to preclinical studies the team conducted, the strongest natural compound identified as oligomycin, had a higher efficacy than sorafenib.
Making Progress On The Global Threat Of Hepatocellular Carcinoma: A Growing Armamentarium
Jolynn K. Sessions, PharmD, the oncology pharmacy manager at the Charles George VA Medical Center in Asheville, North Carolina explained the risk and treatment for Hepatocellular Carcinoma (HCC) at the 2019 Directions in Oncology Pharmacy™ conference. Dr. Sessions stressed the importance of targeted therapies that have proven efficacy in HCC, including agents targeting vascular endothelial growth factor (VEGF) and the programmed cell death protein 1 (PD-1) inhibitors. She presented the evidence behind first-line agents, sorafenib and lenvatinib, administration pearls for their use, and emphasized monitoring considerations.
MRI Finds More Cases Of Liver Cancer Than Ultrasonography In Less Time
According to a study, nonenhanced MRI has been shown as an option for Hepatocellular Carcinoma (HCC) surveillance in high-risk patients. This is based on high-performance results with a short scan time and lack of contrast agent-associated risks. Hyo Jung Park, MD, from University of Ulsan College of Medicine in the Republic of Korea, and colleagues, showed that ultrasonography had a low sensitivity of approximately 63% for detecting early HCC and 20% for very early-stage HCC. The estimated scan time was less than 6 minutes for nonenhanced MRI. However, patient stay duration of MRI was approximately 25 to 35 minutes compared with 12 to 15 minutes for ultrasonography.
Roche’s Phase III Cancer Immunotherapy Trial Reveals Positive Results for Liver Cancer
According to the Phase III IMbrave150 study, the combination immunotherapy, with the PD-L1 inhibitor atezolizumab and the VEGF inhibitor bevacizumab, has shown positive results. The combination works by enhancing the potential of the immune system to fight Hepatocellular Carcinoma (HCC). The study involved 501 patients with unresectable HCC. Results showed a reduced risk of death by 42 % and the risk of cancer progression by 41 % as compared to sorafenib. Professor Pierce Chow, Senior Consultant, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore said, “The impressive results of the IMbrave150 trial offer the possibility that efficacious adjuvant therapy might be possible.”
Precise Radiation To The Tumor Is Safe And Effective In Treating Patients With Liver Cancer
According to a Phase II study, stereotactic body radiotherapy can help patients with Hepatocellular Carcinoma (HCC). The clinical trial involved 65 patients in six institutions in South Korea, to evaluate the safety and efficacy of stereotactic body radiotherapy. At a median follow up of 41 months, the researchers saw low treatment-related severe side effects and a high rate of tumor control. Researchers examined progression-free survival (PFS), or the length of time during and after treatment that patients lived with the disease without their disease worsening, and overall survival (OS). At two years, PFS was 48% and OS was 84%. At three years, PFS was 36% and OS was 76%.
Math Equation Predicts And Detects Liver Cancer
By combining RNA sequencing, bioinformatics and mathematical modeling, the University of California San Diego School of Medicine and Moores Cancer Center researchers identified a sudden switch that turns healthy liver tissue cancerous. Gen-Sheng Feng, Ph.D., professor of in the Department of Pathology and team developed a tumorigenic index score that identifies a shift from healthy to malignant cells. Feng explains, “For the first time, we have a mathematical equation that can predict when healthy liver cells become cancerous.” Transcription factors are proteins that bind to specific DNA sequences in order to direct which genes should be turned on or off in a cell. By quantitatively measuring changes in transcription factors, together with downstream target genes as a unit (transcription factor clusters), the research group analyzed RNA-sequencing data collected in the pre-cancer and cancer stages of mouse models with different forms of liver cancer.
Liver Cancer Symptoms: This Change In Your Stool Color Could Be A Warning Sign
The Mayo Clinic has a list of symptoms to be aware of that may be a warning sign of liver cancer. Individuals with cirrhosis, diabetes, chronic infection with hepatitis B virus or hepatitis C virus, inherited liver diseases like Wilson's disease are more likely than others to get affected by liver cancer. A symptom to be aware of is white, chalky stools. A lack of bile can cause chalky stool. Bile is the digestive fluid produced by your liver and is what gives the normal brown color to your stools when it gets excreted into the small intestine during digestion. Other symptoms of liver cancer include nausea, loss of appetite, unintentional weight loss, general weakness, abdominal swelling, pain in the upper abdomen, and jaundice.
TACE Plus Nexavar For Unresectable HCC Improves Progression-Free Survival
According to a study by Masatoshi Kudo, MD, Ph.D., from the Kindai University Faculty of Medicine in Japan and team, treatment with transarterial chemoembolization (TACE) and Nexavar improved progression-free survival (PFS) compared with TACE alone in patients with unresectable Hepatocellular Carcinoma (HCC). Median PFS of patients who received TACE plus sorafenib was 25.2 months, where the TACE only group saw 13.5 months of PFS. The researchers concluded that pre-treatment with sorafenib 2 weeks to 3 weeks before initial TACE enhanced the treatment effect of TACE.
Liver Cancer: How Certain Factors Influence Survival Rates
Statistics show that since 1980, liver cancer is up 300%, and has been at a steady rate increase of 3% between 2006 to 2015. The 5-year survival rate is only 18%. The 5-year survival rate decreases to 11% if the cancer has metastasized to the surrounding organs and tissues. People of Pacific Island or Asian American descent have the highest rates of liver cancer than any other group. The second highest rates are found in the Latino community, followed by American Indians and Alaska Natives, African Americans, and whites. Men are 3 times more likely to develop liver cancer than women and are much more likely to have Hepatocellular Carcinoma (HCC) than women.
Frontline Nivolumab Demonstrates Survival Benefit Over Sorafenib In Advanced HCC
The results of the phase III CheckMate 459 trial, which included 743 patients, demonstrated improvement in overall survival (OS) with the treatment of nivolumab (Opdivo) versus sorafenib (Nexavar) in patients with unresectable Hepatocellular Carcinoma (HCC). The median OS of patients who received nivolumab was 16.4 months versus 14.7 months with sorafenib. Median PFS in the nivolumab arm was 3.7 months versus 3.8 months in the sorafenib arm.
Stamping Out Liver Cancer With Inhibitor Drugs
A team of researchers led by Associate Professor Edward Chow at the National University of Singapore (NUS) has found that a class of small molecule drugs inhibiting the JAK/STAT signaling pathway in liver cancer cells could be useful for treating Hepatocellular Carcinoma (HCC). The team found that JAK/STAT signaling is active in some cancer cells and has stem-like properties, which means that they can self-renew and create more cancer cells. They found that, in mice, cancer cells were reduced by 50% when the treated with a JAK/STAT pathway inhibitor.
Tetra Bio-Pharma Provides Update On Its Hepatocellular Carcinoma Drug HCC011
Tetra Bio-Pharma Inc. has developed the new drug HCC011, inhaled delta-9-tetrahydrocannabinol (THC), for the treatment of Hepatocellular Carcinoma (HCC). Tetra is a biopharmaceutical leader in cannabinoid-based drug discovery and development. Tetra will be meeting with the FDA to file for Orphan Drug status for HCC011. Orphan drug designation extends several benefits, including a seven-year marketing exclusivity, and tax credits of 50% of the clinical drug testing cost awarded upon approval.
Drinking This Amount Every Day Linked To 30% Cancer Risk Increase
Based on the results of a cohort study, conducted on residents of Japan, examining medical history over several decades, researchers concluded that even light alcohol consumption is associated with a risk increase for developing cancer over time. The team defined light to moderate drinking as a two-ounce shot of whiskey, a six-ounce glass of wine, or a 17-ounce glass of beer. Light drinkers were associated with a 5% risk increase for developing cancer. People who drank moderately saw an 18% risk increase.
New Startup Aims To Prevent Reperfusion-Related Organ Damage After Liver Transplant
Ischemia, or lack of blood supply, to a transplanted organ is a significant obstacle patients experience. While a constant supply of blood is necessary for fresh oxygen and nutrients, a sudden surge of blood to the transplanted organ, known as reperfusion, can flood cells with oxygen. This can lead to the production of free radicals that trigger inflammation-causing organ damage. Lydex Pharmaceuticals, with a grant from the National Institutes of Health, sets out to develop a new approach to prevent reperfusion-related organ damage after liver transplant. MUSC researchers C. James Chou, Ph.D., a medicinal chemist; Sherine Chan, Ph.D., a mitochondrial biologist; and College of Charleston chemist Richard Himes, Ph.D., founded Lydex.
Survival Benefit Confirmed In Real-Life Analysis Of Second-Line Regorafenib In HCC
Based on data from the phase III RESORCE trial, regorafenib (Stivarga) was approved by the FDA as a second-line treatment of patients with Hepatocellular Carcinoma (HCC) who have progressed on prior sorafenib (Nexavar). The survival for second-line regorafenib was estimated at 28 months versus 8 months with sorafenib, based on the findings of María Varela, MD, Ph.D., a pathologist in the Liver Unit at the Hospital Universitario Central de Asturias.
Discovering Possible Treatments For Liver Cancer
Researchers from Duke-NUS Medical School have found that a specific group of self-regenerating liver cells can turn into cancer cells and lead to the development of Hepatocellular Carcinoma (HCC). The team created “genetic lineage tracing” to find out whether these cells would become cancer cells when injuries to the liver last for a long period of time. They used this method to research hepatocytes, the chief functional cells of the liver, which produce the protein Lgr5 under different conditions. They found that with injured liver cells, hepatocytes were susceptible to turning into cancer cells.
Treating Liver Diseases: Is This Preclinical Model The Solution?
In preclinical research, the most important aspect is understanding the metabolites of a certain drug and whether they are toxic to humans in any way. Preclinical research involves animals, and though they may not show signs of toxicity, it may still be toxic to humans. TransCure BioServices is developing new preclinical models with a human liver, called the hu-liver mouse models. In the hu-liver mouse model, the mouse hepatocytes are replaced with human hepatocytes. Therefore, the function of the animal liver is very similar to a human liver. Now the models will have a full human immune system that can be used for predictive research.
Tetra Bio-Pharma Receives FDA Orphan Drug Designation For Hepatocellular Carcinoma
Tetra Bio-Pharma Inc., a biopharmaceutical company focused on cannabinoid-derived drug discovery and development, has been granted Orphan Drug Designation for delta-9-tetrahydrocannabinol (THC) in the treatment of Hepatocellular Carcinoma (HCC) by the FDA. “We are very pleased to have received Orphan Drug Designation (ODD) from the FDA for THC. This second ODD for cannabinoids demonstrates our innovation and successful drug development program that will soon include Hepatocellular Carcinoma," said Dr. Guy Chamberland, CEO and Chief Regulatory Officer of Tetra Bio-Pharma. Tetra will use the pharmacokinetic and safety data from its Caumz™ Phase I clinical trial to support its Phase II trial of a modified formulation Caumz™ in patients with HCC.
USA Health Surgical Oncologist Performs First Robotic Liver Resection In South Alabama
Annabelle L. Fonseca, M.D., M.H.S., an assistant professor of surgery at the University of South Alabama College of Medicine, performed the first robotic liver resection in the southern part of Alabama at USA Health University Hospital. Robotic liver resection is a surgical technique in which a surgeon can reach and remove liver tumors using tiny incisions in a minimally invasive approach and avoiding a large incision to the patient. The liver is not easily accessible for standard surgery, because it is tucked away in the right upper portion of the abdomen and requires a large incision that extends under both sides of the ribs or starts under the ribs and extends to the mid-abdomen. According to Fonseca, faster recovery from surgery allows cancer patients to start or return to chemotherapy quicker.
3-D Model Of Human Liver For Better Diagnosis
Researchers at the Max Planck Institute of Molecular Cell Biology and Genetics with colleagues from the Technische Universität Dresden have been able to generate 3-D geometrical and functional models of the human liver tissue for different disease stages. The standard histological analysis of liver tissue for diagnosing disease progression has several disadvantages, including low resolution 2-D images of liver tissue. In 2017, Marino Zerial and his team first developed a model of the bile canalicular network and bile flow in the mouse liver using multi-resolution 3-D analysis of its geometry. The next step was a 3-D digital reconstruction that was then used to computationally simulate bile fluid dynamics through a model created by the Center for Information Services and High Performance Computing.
Atezolizumab Plus Bevacizumab Extends Survival In Unresectable HCC
According to the results of the randomized phase 3 Imbrave150, the combination of atezolizumab and bevacizumab had meaningful improvements in progression-free survival (PFS) and overall survival (OS) as compared with sorafenib among patients with unresectable Hepatocellular Carcinoma (HCC). Ann-Lii Cheng, MD, Ph.D., director of National Taiwan University Cancer Center, and team randomly assigned 501 treatment-naive patients. Patients who received atezolizumab plus bevacizumab had an average PFS of 6.8 months, and patients who received sorafenib had an average PFS of 4.3 months.
Frontline I/O Therapy For HCC: Results From Checkmate459
The CheckMate459 was a phase III study investigating the survival advantage of nivolumab versus sorafenib for patients with Hepatocellular Carcinoma (HCC). The overall survival (OS) rate was 16.4 months for patients taking nivolumab, versus about 15 months for patients taking sorafenib. According to Nikolaos Pyrsopoulos, MD, Ph.D., “I think the study definitely failed to demonstrate the statistically significant improvement for the overall survival. On the other hand, I do think none of us can deny the true value for checkpoint inhibitors because we have seen it in our clinical practice.”
Researchers Discover New Method To Reduce Chemo Doses For Patients
While chemotherapy is the standard treatment for cancer patients, it is extremely painful and forces many patients to stop treatment. A team of researchers led by Professor Alexander Binshtok, head of Plain Plasticity Research Group at the Hebrew University of Jerusalem, has developed a method that delivers chemotherapy drugs directly to malignant cells and bypasses healthy ones. The team created a study that focused on the selective expression of the TRPV2 protein by cancer cells. When activated, TRPV2 protein opens a canal inside cell membranes through which they were able to successfully insert a low dose of doxorubicin, a chemotherapeutic agent directly into cancer cells. Future treatments using this new method may allow doctors to prescribe lower chemo doses.
Can-Fite Biopharma Ltd Rallies On Positive News About Liver Cancer Treatment
Can-Fite Biopharma Ltd is a pharmaceutical company that makes small molecule therapies for treating cancer and other inflammations of the liver. The company recently announced that its phase II meeting with the FDA had been a success. Their Phase II trial was for Namodenoson, a treatment for Hepatocellular Carcinoma (HCC). Based on Phased II data the FDA had agreed with the proposed phase III. Namodenoson is part of the company’s program for treating HCC patients under the compassionate use program, which means that patients are treated with Namodenoson after all other treatment options have been exhausted and are no longer reasonable.
Four Terrifying Signs That Could Mean You Are Suffering From Liver Cancer
According to Cancer Research UK, the number of deaths from liver cancer has risen by around 50% in the past decade in the UK. Doctors are urging adults to take proactive measures if any of the warning signs arise. The warning signs include rapid weight loss, loss of appetite, sudden unexplained feelings of fullness, and a lump on the right side of the abdomen. Although a person's weight can fluctuate, a persistent loss which is beyond 5% of your weight in less than three months could be a sign. A loss of appetite is concerning if you must constantly remind yourself to eat. Self-checks for lumps throughout the entire body should be done on a regular basis.
Choosing Between Systemic Therapy And TACE For HCC
Mark Yarchoan, MD, assistant professor of oncology at Johns Hopkins Medicine in Baltimore, Maryland, explains, “Sorafenib [Nexavar] beats supportive care, so there is clear evidence that we have systemic therapies that work” as first-line therapy for nonresectable, non– transplant eligible, Hepatocellular Carcinoma (HCC). To support his claim, the double-blind, placebo- controlled phase III trial of 602 patients with advanced HCC who had not received prior systemic therapy showed median overall survival of 10.7 months with sorafenib versus 7.9 months with placebo. Another study, conducted by the Barcelona Clinic Liver Cancer group, showed that chemoembolization was superior for survival with a 2-year survival probability of 50% for embolization and 63% for chemoembolization.
How Cannabis Could Be A First Step In Treating Liver Cancer
A team of researchers at the Hebrew University of Jerusalem have developed a method to deliver chemotherapy drugs used to treat liver cancer directly to malignant cells while bypassing healthy ones. The method involves a combination of cannabidiol, found within the cannabis plant, and a low dose of doxorubicin, a chemo-therapeutic drug. Prof. Alexander Binshtok, head of the Pain Plasticity Research Group at the Hebrew University’s Faculty of Medicine explains that most cancer treatments cannot always target just the bad cells-the healthy cells are affected by the treatment as well. The team has shown that liver cancer cells express a specific protein called TRPV2, which, when activated, creates a channel into the otherwise impenetrable membrane. Healthy cancer cells do not have this protein. CBD can be used to open this channel and then a low dose of the drug can be inserted to kill the cancer cells.
Encouraging Normal Liver Cells To Fight Cancer
A team of researchers at the VIB-KU Leuven Center for Cancer Biology in Belgium have discovered that healthy liver tissue surrounding a tumor activates a defense mechanism that can restrain tumor growth. The study was led by Prof. Georg Halder. Through mouse models, the team non-cancerous liver cells around liver tumors can kill nearby tumor cells. Further research shows that when the genes YAP and TAZ were activated around tumors in the liver, this was the driving force of the anti-tumor mechanism. Hyperactivation of this mechanism, above normal levels in the liver, triggered the elimination of different types of liver tumors in mice.
Genetic Research Declares War On Liver Cancer
Researchers at UZA and UAntwerp discovered a set of genes that can predict who is likely to develop liver cancer. A cure for liver cancer is possible when the disease is caught early on. Unfortunately, the early state is seldom detected. The team, led by Prof. Kris Laukens and Dr. Bart Cuypers, developed and artificial intelligence computer model. The model collects the following data: level of liver damage, biopsy data, and the genetic details of the patient. "This enables us to recognize patterns that will lead to the development of liver cancer more than eight years down the line," explains one of the scientists.
The Link Between Viruses And Cancer
Although cancer is not contagious, the viruses that can cause cancer are contagious. Most of these viruses can be eradicated with the currently available vaccines and patient screening. Hepatitis B and C viruses are responsible for approximately 80% to 95% of all liver cancers. Hepatitis B is a liver infection transmitted through bodily fluid, and hepatitis C is a blood-borne virus most commonly transmitted by sharing needles. There is currently no cure for hepatitis C. Doctors strongly urge everyone to be regularly tested.
Combination Therapy Improves Survival In Patients With Hepatocellular Carcinoma
According to the results from a phase 3 study, the combination therapy with the PD-L1 inhibitor atezolizumab, and the VEGF inhibitor bevacizumab, significantly improves overall survival (OS) and progression-free survival(PFS) in patients with unresectable Hepatocellular Carcinoma (HCC) compared to standard of care. Atezolizumab reactivates the immune response to tumor cells while bevacizumab stops the tumors from growing new blood vessels and obtaining nutrients and oxygen. The phase 3 IMbrave150 study was led by Ann-Lii Cheng, Director of the National Taiwan University Cancer Center, Taipei, Taiwan. The study showed clinically meaningful results.
Roche Says Tecentriq Cocktail Helps Liver Cancer Patients Live Longer
Roche's immunotherapy treatment, Tecentriq, along with Avastin, has helped liver cancer patients live longer when compared to Bayer’s drug, sorafenib. Median overall survival for patients with unresectable Hepatocellular Carcinoma (HCC)who received both treatments simultaneously was 13.2 months. Roche is currently competing with Keytruda from Merck and Opdivo from Bristol-Myers Squibb. Based on the researcher's results, Roche will seek liver cancer treatment approval for the Tecentriq-Avastin cocktail.
Proton Beam Therapy: A Less Toxic Option In Liver Cancer
Based on two new studies proton radiation therapy may offer the same benefits as photon radiation therapy, but with less toxicity, for inoperable Hepatocellular Carcinoma (HCC). The lead investigators of these two studies are Dr. Nina Sanford, assistant professor of radiation oncology at the University of Texas Southwestern Medical Center, and Dr. Cheng-En Hsieh, a radiation oncologist at The University of Texas MD Anderson Cancer Center and Chang Gung Memorial Hospital in Taiwan. Dr. Sanford’s study showed that both proton and photon radiotherapies provided similar tumor control benefits for localized HCC. Patients treated with protons had a lower risk of treatment-related liver disease and prolonged median survival compared with those treated with photons.
Medivir AB has recruited nine patients for their phase Ia study of MIV-818 in patients with advanced liver cancer. MIV-818 is designed to selectively treat liver cancers and to minimize side effects. It has the potential to become the first liver-targeted, orally administered drug to benefit patients with Hepatocellular Carcinoma (HCC). Phase Ia is an interpatient study. Phase Ib is based on a dose-escalating design. This will help decide the dose in the Phase II study. Medivir had previously reported that the intended liver-directed effect of MIV-818 could be verified from data from the first six patients.
Liver Cancer Clinical Trial Only Available In Hawaii
The University of Hawaii Cancer Center has begun a new clinical trial combining two different immunotherapy medications against liver cancer. The trial is being conducted at Hawaii Cancer Consortium network sites, Hawaii Cancer Care, Inc. and Hawaii Oncology, Inc. The trial will test how the anti-TIM-3 antibody and anti-PD-1 antibody work in combination to shrink tumors by allowing the immune system to destroy cancer cells. The UH Cancer Center is the only institution approved by the FDA to test the two agents in combination for the specific treatment of liver cancer. “Many patients with liver cancer will present at an advanced stage. For these patients, immunotherapy, medicine to enhance the immune system, is one of the most effective treatments,” said Jared Acoba, principal investigator of the trial and assistant professor at the UH Cancer Center.
The FDA has accepted a supplemental Biologics License Application (sBLA) and granted the Breakthrough Therapy Designation for nivolumab (Opdivo) in combination with ipilimumab (Yervoy) for the treatment of advanced Hepatocellular Carcinoma (HCC) in patients who were previously treated with sorafenib. Opdivo and Yervoy are developed by Bristol-Myers Squibb Company. The sBLA is based on data from the phase 1/2 CheckMate-040 study. “Despite recent advances, HCC remains a difficult-to-treat cancer....we look forward to working with the FDA to bring the potential of a dual immuno-oncology therapy to these patients for the first time,” said Ian M. Waxman, MD, development lead of Gastrointestinal Cancers at Bristol-Myers Squibb.
Treatment involving tenofovir (TDF) and entecavir (ETV) in patients with chronic hepatitis B (CHB) has led to a decrease in the incidence of Hepatocellular Carcinoma (HCC). A research team analyzed 3,022 patients with CHB who were treated with TDF or ETV at the Catholic University of Korea. The team sought to compare TDF and ETV on the risk of HCC and mortality. The team found no difference between TDF and ETV in the incidence rates of HCC in the entire cohort. Also, no difference was observed between TDF and ETV in the incidence rates of all-cause mortality or liver transplantation. The team concluded that there was no notable difference in the intermediate-term risk of HCC and mortality between the two drugs.
Exact Sciences (Exas) Presents Data On Blood-Based Test For Detection Of Hepatocellular Carcinoma
Exact Sciences Corp. has demonstrated 80% sensitivity at 90% specificity with a new combination of six blood-based biomarkers for Hepatocellular Carcinoma (HCC). The study involved 443 patients. Based on study results the FDA has granted Breakthrough Device designation, which expedites development, assessment, and the review processes, to provide patients and providers with timely access to new technologies. The accuracy of both Exact Sciences' HCC test and the AFP blood test were analyzed for all Barcelona Clinic Liver Cancer (BCLC) stages and for early stage HCC. The test demonstrated 71% sensitivity for early-stage HCC, compared to the AFP test, which detected 45% of early stage cancers and 62% of cancers across all stages in Exact Sciences' study.
Coffee Drinkers At Lower Risk Of Most Common Liver Cancer
A research team from Queen’s University, Belfast has reported that coffee drinkers have a lower risk of suffering the most common type of liver cancer, Hepatocellular Carcinoma (HCC). Their finding is based on a 7.5-year study that took place in Britain and Northern Ireland looked at the coffee-drinking habits of 471,779 participants in the UK Biobank. The researchers found that coffee drinkers were 50% less likely to develop HCC, as compared to those who did not drink coffee. Kim Tu Tran, a postgraduate research student from the Centre for Public Health at Queen’s University, stated: “People with a coffee-drinking habit could find keeping that habit going is good for their health.”
Investigators Explore Neoadjuvant Immunotherapy In Hepatocellular Carcinoma
Surgery is the standard of care for patients with localized solid tumors. Patients at high risk of systemic relapse are usually recommended for adjuvant therapy to reduce the risk and improve the rate of cure. The newest idea of some scientists is neoadjuvant treatment, which means before surgery. One of the main advantages of neoadjuvant therapy involved in vivo assessment of treatment effectiveness, which can then inform prognosis and therapy. However, if residual muscle-invasive disease is present, even after neoadjuvant chemotherapy, the patient is at a higher risk of relapse.
The Data Monitoring Committee (iDMC) has unanimously recommended that the OPTIMA Study continue. The OPTIMA Study enrolled 556 patients from 65 clinical sites in 14 countries. Celsion Corporation, an oncology drug development company has been working on a double-blind, placebo-controlled Phase III study with ThermoDox® plus RFA (radiofrequency ablation) in patients with Hepatocellular Carcinoma (HCC). ThermoDox® is a lyso-thermosensitive liposomal doxorubicin (LTLD), which delivers high concentrations of doxorubicin to a specific region at a temperature that is just above the normal body temperature. Median progression-free survival (PFS) for the OPTIMA study reached 17.3 months.
Research Suggests Proton Radiation Therapy Can Benefit Patients With Challenging Liver Tumors
Proton radiation therapy is an effective treatment for patients with Hepatocellular Carcinoma (HCC). This information is supported by two recent studies. The first study was led by Nina Sanford, M.D., and colleagues at Massachusetts General Hospital. Sanford and team showed that proton radiation can extend overall survival with reduced toxicity, as compared to traditional photon radiation. The median survival of patients using proton radiation was 31 months vs. 14 months with photon radiation. The second study, completed by Cheng-En Hsieh, M.D., and colleagues, identified predictors for reducing liver damage that can result from radiation treatments. They found that the amount of the liver that was not affected by radiation was more important than the dose of radiation.
PET Imaging Sheds Light On Immunotherapy Response
Immunotherapy with checkpoint inhibitors, which block the proteins that stop the immune system from attacking cancer, is becoming an increasingly important tool in the treatment of several cancers. The presence of CD8+ T cells, which are important in anti-tumor immune responses, are a key determinant of successful checkpoint blockade therapy. In a clinical trial, sponsored by ImaginAb and lead at the Memorial Sloan Kettering Cancer Center, scientists performed the first-in-human imaging of a tracer designed to non-invasively visualize the immune system. The team used 89Zr-IAB22M2C, a minibody (antibody fragment) designed to target CD8+ T cells.
Can-Fite completed its Phase II liver cancer study which found that Namodenoson increased overall survival in Hepatocellular Carcinoma (HCC) patients. Although the trial did not meet its primary endpoint, Can-Fite recently completed a successful End-of-Phase II meeting with the U.S. FDA for a Phase III study. Namodenoson is a small oral drug that binds to the A3 adenosine receptor (A3AR) and is being evaluated as a second-line treatment for HCC. “We are grateful to Dr. Stemmer for leading this compassionate use program, making Namodenoson available to patients who have exhausted all other treatment options...Can-Fite is committed to providing Namodenoson to fulfill the unmet medical need in this population,” stated Can-Fite CEO Dr. Pnina Fishman.
Deaths From Liver Cancer Have Tripled In Past 20 Years In England
According to new research to be presented at the 2019 NCRI Cancer Conference, more people are being diagnosed with and dying from liver cancer in England. Between 1997 to 2016, incidence and deaths from the most common form of the disease, Hepatocellular Carcinoma (HCC), have tripled. Dr. Anya Burton, a cancer epidemiologist at Public Health England, and her team found that among men, rates increased from 2.73 cases of HCC diagnosed and 1.93 deaths per 100,000 in 1997 to 8.82 and 5.97 respectively, per 100,000 in 2016. Among women, the rates increased from .82 cases diagnosed and 0.51 deaths per 100,000 in 1997 to 2.2 and 1.4 per 100,000 respectively in 2016.
Chinese Scientists Develop New Material For Treatment Of Liver Cancer
According to the Suzhou Institute of Biomedical Engineering and Technology under the Chinese Academy of Sciences, scientists have developed a nanometer material that can be used for liver cancer treatment. The material provides an efficient and safe strategy for treating liver cancer when integrated with radiotherapy. The material is made of silicon dioxide and gold and measures about 200 nanometers long and 100 nanometers wide. The team has shown that in experiments on mice with liver cancer nanoparticles enhanced the sensitivity of tumor tissue to radiation and that the gold is effective in fighting tumors.
Scientists Develop New Material For Liver Cancer Treatment
Chinese scientists of the Suzhou Institute of Biomedical Engineering and Technology under the Chinese Academy of Sciences have developed a material that can be used for liver cancer treatment. The material is a nanoparticle made of silicon dioxide and gold. As a treatment, it can be filled with telazamine, a drug that enhances anti-tumor effects, and injected intravenously. Given its size, it can reach hypoxic microenvironments which are prevalent in solid tumors, and not sensitive to radiation, allowing cancer cells to survive This new material the material provides an efficient and safe strategy for treating liver cancer, explained the team.
Can-Fite BioPharma Ltd., a biotechnology company, has concluded an End-of-Phase II Meeting with the U.S. Food and Drug Administration (FDA). The meeting was regarding its recently completed Phase II study of Namodenoson for the treatment of hepatocellular cancer (HCC). Namodenoson is a small oral drug that binds to the A3 adenosine receptor (A3AR), which is highly expressed in diseased cells. The purpose of the meeting was to review the Phase II study data and propose a Phase III study. The Phase II study found that Namodenoson increased overall survival in HCC patients. The Phase III study will enroll patients with advanced HCC.
New Research Suggests Proton Radiation Can Benefit Patients With Challenging Liver Tumors
The publication of two new studies finds that the use of proton radiation therapy to treat patients with Hepatocellular Carcinoma (HCC) may be beneficial. One study, by Nina Sanford, MD, and colleagues at Massachusetts General Hospital, suggests that proton radiation, compared to traditional photon radiation, can extend overall survival (OS) with reduced toxicity. Stanford's study showed a median OS to be 31 months using proton radiation, vs. 14 months using photon radiation. The other study by Cheng-En Hsieh, MD, and colleagues identifies predictors for reducing liver damage that can result from radiation treatments. While proton therapy may offer advantages, it is expensive and not easily available to most patients.
Integrating Palliative Care Into Hepatocellular Carcinoma Treatment
Hepatocellular Carcinoma (HCC) affects 30,000 adults in the United States each year and is more prevalent in men than women. The 5-year survival rate in patients with HCC is less than 12% in the US. Doctors believe that in addition to hepatologists and other specialists in the management of patients with HCC, early and consistent palliative support could enhance care throughout the disease course. Palliative support consists of relieving pain associated with the disease or the side effects of treatment. “Palliative care clinicians are uniquely suited to help patients navigate the process of treatment decisions while considering how to best define and maintain quality of life while living with a serious illness like HCC,” explained the researchers.
Scientists Discover The Implication Of A New Protein Involved In Liver Cancer
Researchers at the Bellvitge Biomedical Research Institute (IDIBELL) discovered how the cell membrane protein is involved in the development and progression of liver cancer. This protein, called clathrin, has a key role in the process of internalization of molecules from the extracellular space into the cell, called endocytosis. Analyzing the levels of clathrin expression in biopsies of Hepatocellular Carcinoma (HCC) patients will help select patients who will benefit from a much more targeted and personalized therapy. The research team, led by Dr. Isabel Fabregat, professor at the Faculty of Medicine and Health Sciences of the University of Barcelona and a researcher at the CIBER of Hepatic and Digestive Diseases, has shown that liver cells with invasive features have high levels of clathrin.
New Diagnostic Method To Determine Liver Cancer Consistency
Researchers from Charité-Universitätsmedizin Berlin developed a new diagnostic technique of grading tumor consistency using magnetic resonance imaging (MRI). The researchers used an imaging technique known as tomoelastography to visualize the liver tumors. A research team, led by Prof. Ingolf Sack of Charité's Department of Radiology on Campus Charité Mitte, used a technique known as tomoelastography and became the first researchers to show a link between the tissue's solid-fluid properties and the development of liver tumors. The study showed that hepatic malignancies contain tissues with both stiff and fluid properties. Also, people with increased liver stiffness are at a greater risk of developing malignant liver lesions.
Statins Reduce Risk Of Hepatocellular Carcinoma
According to the results of a review and meta-analysis conducted by Cleveland Clinic investigators, statin use substantially reduces the risk of Hepatocellular Carcinoma (HCC). The review included 20 studies from Asia, Europe and the United States that represented more than 2.6 million patients. Gastroenterologist Carlos Romero-Marrero, MD, the study’s principal author, stated, “We found that patients who were taking statins were 43% less likely to develop HCC. Given this finding, statins should be considered as preventive therapy in patients at high risk of HCC.” Although the effects of various individual statins and their optimal dosages are not defined yet, the meta-analysis found that as the daily statin dose increased, the chances of HCC development decreased significantly.
Microbiome-Derived Therapy Gets Orphan Drug Status For Hepatocellular Carcinoma
The Food and Drug Administration (FDA) has granted Orphan Drug designation to SFA001 (SFA Therapeutics) for the treatment of Hepatocellular Carcinoma (HCC). In animal models, SFA001 has shown to significantly reduced the number of HCC tumors as well as the size of the tumors. SFA001 is a microbiome-derived drug that is developed from natural substances. “By granting an Orphan Drug designation to SFA001, FDA has given a special status to treatment of the most prevalent form of liver cancer,” stated Ira Spector, PhD, SFA Therapeutics’ CEO. “These advantages undoubtedly will speed the drug’s availability for a disease that kills hundreds of thousands of patients annually worldwide.”
Andrea Wilson Woods, author of Better Off Bald: A Life in 147 Days, chronicles her sister’s remarkable life, from the time she was born to the day she died at age fifteen. The books is written as a journal to take the reader inside her and Adrienne’s journey. Woods explains that she decided to write this book to spread awareness of liver cancer and share Adrienne’s story. Liver cancer is one of the deadliest cancers worldwide. In the book, Woods also embraces the lessons Adrienne taught her, “If we embrace change, miraculous things happen. That’s the single biggest lesson that I learned from my sister.”
Contrast-Enhanced Ultrasound Predicts Nodule Transformation To Hepatocellular Carcinoma
Lead investigator Manxia Lin of China's Sun Yat-Sen University retrospectively studied 39 consecutive patients with 44 pathologically confirmed cirrhotic nodules. These patients initially underwent contrast-enhanced ultrasound (CEUS) examination at detection, followed by conventional ultrasound every 3-4 months thereafter. The team identified sonographic biomarkers that can predict eventual malignant transformation of pathologically confirmed cirrhotic nodules for patients at risk for Hepatocellular Carcinoma (HCC). The team also found that the absence echo image change and threshold growth "significantly excluded malignant transformation." Lin stated, “During surveillance a relative growth rate of 30% or greater in 6 months or an absolute growth rate of 5 mm or greater in 6 months highly indicated malignant transformation."
Combination Therapy Shown To Increase Overall Survival And Progression-Free Survival For HCC
Genentech's Phase III study showed that atezolizumab (Tecentriq, Genentech) in combination with bevacizumab (Avastin, Genentech) increased overall survival (OS) and progression-free survival (PFS) in patients with unresectable Hepatocellular Carcinoma (HCC). The IMbrave150 study includes 501 people with unresectable HCC who have not received prior systemic therapy. Atezolizumab is an antibody that binds with a protein expressed on tumor cells and tumor-infiltrating immune cells and may be able to re-activate T-cells. Bevacizumab is a biologic antibody that interferes with the tumor blood supply, which is believed to be vital for a tumor to metastasize. The combination treatment met both of its coprimary endpoints and demonstrated statistically significant and clinically meaningful improvements compared with sorafenib.
Liver Pathobiology's Role In Hepatocellular Carcinoma
Dr. Ghassan Abou-Alfa, and a panel of multidisciplinary experts in Hepatocellular Carcinoma (HCC) discuss different treatments. Michael A. Morse, MD, MHS, FACP explains that a major finding in immunotherapy is this observation that once immune cells, T-cells, get to the tumor, their function is shut down. This appears to be a function of a molecule called PD-L1, which is deployed by an immune cell to protect itself. PD-L1 interacts with PD-1 on activated T-cells and causes functional demise of those T-cells. Essentially, the PD-1 is preventing the T-cells from touching the cancer cells. CTLA-4 (cytotoxic T-lymphocyte–associated protein 4) is then used to awake the T-cells again so that they start functioning again.
PHGDH Identified As A Potential Target To Overcome Sorafenib Resistance In HCC
Researchers stated that a gene called phosphoglycerate dehydrogenase (PHGDH)may be a possible agent for overcoming sorafenib resistance for patients with Hepatocellular Carcinoma (HCC). The team found 984 genes that may potentially contribute to sorafenib resistance in HCC using the CRISPR/Cas9 knockout library screening. They also found that when nude mice were treated with sorafenib and CT-503, a PHGDH inhibitor, this “completely halted” tumor growth. Then, when this treatment was combined with other tyrosine kinase inhibitors (TKI) inhibitors such as regorafenib or lenvatinib, this resulted in “profound” apoptotic effects, according to the study authors.
Level Of Hepatitis B Core-Related Antigen And Risk For Hepatocellular Carcinoma
According to a recent cohort study, high level of hepatitis B core-related antigen (HBcrAg) is a complementary risk factor for Hepatocellular Carcinoma (HCC) development. Data was collected from 2666 adults positive for hepatitis B surface antigen (HbsAg) and infected with HBV. Of those patients, 209 developed HCC. The researchers concluded that there was a positive association between baseline of HBcrAg and HCC development.
Challenges Remain In Hepatocellular Carcinoma Surveillance Of Patients With NASH
“Overall, when you look at all patients with cirrhosis, less than 20% receive regular surveillance every 6 months, and it’s even lower for that subgroup with NASH cirrhosis,” said Amit Singal, MD, MS. Researchers have shown that Hepatocellular Carcinoma (HCC) incidence in patients with nonalcoholic steatohepatitis (NASH)-related cirrhosis is high enough for surveillance to be cost-effective. Currently, ultrasound and blood test for the alpha-fetoprotein (AFP) biomarker are the recommended tests for HCC. Unfortunately, ultrasound has a sensitivity rate of 47% for detecting HCC at the early stage. The curative treatment options for early-stage HCC include liver resection, local ablation, and transplantation.
'Eisai's Lenvima Extends Survival Period, Improves Patients’ Quality of Life'
According to recent research results, Lenvima, a Hepatocellular Carcinoma (HCC) treatment, has been shown to improved response rate and overall survival, compared to Nexavar. Lenvima, developed by Eisai, has gained insurance benefits from the Ministry of Food and Drug Safety as a first-line treatment for unresectable advanced HCC, based on the results of the phase 3 clinical trial REFLECT study. Professor Yoo Chang-hoon at Asan Medical Center explained that the objective response rate was more than doubled,24.1 % as compared to 9.2 % with Nexavar.
Radio Device Shows Promise As Liver Cancer Treatment, NC Study Finds
Researchers from Wake Forest Baptist Health are working to get FDA approval for a treatment device called Therabionic that kills tumor cells of Hepatocellular Carcinoma (HCC). The device uses amplitude-modulated (AM) radio waves and transmits them at a tumor-specific frequency through the patient, treating the body as an antenna. Dr. Boris Pasche, the study leader, explains that one benefit of the treatment is that it’s “systemic,” which means it goes through the entire body and can affect all cancer cells instead of just one area. Their research shows that the waves have shown no effect on other cells.
Liver cancer falls into two categories, primary liver cancer, when the cancer originates in the liver, and secondary liver cancer which is the result of chronic liver injury such as chronic viral hepatitis B or hepatitis C. Hepatocellular Carcinoma (HCC) is the most common type of primary liver cancer. Surgery is the best treatment in the early stage of HCC. In the intermediate stage, yttrium-90, a radioactive nuclide coated on tiny spheres, is introduced as a treatment. Once the tumors are downsized, liver transplant can become a treatment option.
Liver Cancer Awareness Month: What You Need To Know
October is liver cancer awareness month. Recent studies show that taking aspirin was found to improve liver function and extend survival among patients with Hepatocellular Carcinoma (HCC). Researchers have also found a biomarker that may help to determine which patients with HCC will respond to treatment with Nexavar. Scientists are now focusing on the optimal sequence of treatments for patients. Andrea Wilson, president and founder of Blue Faery: The Adrienne Wilson Liver Cancer Association discusses new treatment options.
Potential Molecular Markers in Liver Cancer
Anuradha S. Budhu, PhD, senior associate scientist, Laboratory of Human Carcinogenesis, explains how to use molecular features as predictive markers in liver cancer. Since genes are an important molecular feature, a team of investigators compare normally expressed genes with dysregulated or overexpressed genes to gain insight on cancer biology. Other markers include, microRNAs and downstream affecters of gene signaling such as metabolites and proteins. Markers may help identify liver cancer in patients, predict how aggressiveness the disease is, and determine which patients will benefit the most from treatment.
Frontline Opdivo May Improve Survival, Quality Of Life But Further Evaluation Is Needed
Results from the CheckMate 459 study show that treatment with Opdivo (nivolumab) improved overall survival (OS) and response rates among patients with advanced Hepatocellular Carcinoma (HCC) as compared with Nexavar (sorafenib). Unfortunately, the study did not meet its primary endpoint for improved OS. Patients treated with Opdivo experienced a median overall survival of 16.4 months, compared with 14.7 months in those treated with Nexavar. However, the team found that patients treated with Opdivo experienced improved quality of life. Also, the overall response rate was 15% for those treated with Opdivo, and included 14 patients who experienced a complete response, compared with 7% of those treated with Nexavar, and included five patients with a complete response.
Researchers Try "One-Two Punch" Method To Treat Liver Cancer
Researchers from Shanghai Jiao Tong University's School of Medicine and the Netherlands Cancer Institute have found a "one-two punch" method to treat liver cancer by inducing weakness in liver cancer cells and exploiting the vulnerability to reduce tumor growth. The team found that they can selectively induce senescence, the loss of a cell's power of division and growth, in liver cancer cells with mutations in the gene TP53. Treatment results showed a reduction of tumor growth in mouse models of liver cancer.
Scientists Find Link Between Liver Cancer And Plant Acids
The team led by Shanghai’s Zhongshan Hospital and two Shanghai institutes under Chinese Academy of Sciences have discovered that one-third of liver cancer samples feature a mutation caused by aristolochic acids found in some herbal plants. The researchers found many hepatitis B patients in China have received traditional Chinese medicine treatment (TCM). Improper TCM use was connected with liver cancer. China has banned the use of herbs with high content of aristolochic acids.
Potential Liver Cancer Treatment By Targeting Cancer Stem-Like Cells9
A team led by Associate Professor Edward Chow, Principal Investigator with the Cancer Science Institute of Singapore (CSI) at NUS and Dr Toh Tan Boon, head of the Translational Core Laboratory at NUS have demonstrated a new method for treating advanced liver cancer. Scientists showed that a class of small molecule drugs that target the JAK/STAT signaling pathway, an important set of proteins that control a wide range of biological functions, could be used to fight against HCC. Their study targeted the JAK/STAT pathway to inhibit its action in tumor formation. JAK/STAT inhibitors targeting cancer stem-like cells were able to reduce cancer progression in pre-clinical models of liver cancer.
Addition OF Doxorubicin TO Sorafenib IN Advanced Hepatocellular Carcinoma
The Phase III Alliance/CALGB 80802 trial has not shown any progression-free survival (PFS) or overall survival (OS) benefit with the addition of doxorubicin to sorafenib in patients with advanced Hepatocellular Carcinoma (HCC). The study involved 356 patients and was stopped early due to futility. Median OS was 9.3 months in the combination group who received doxorubicin plus sorafenib, as compared to 9.4 months in the sorafenib-only group, and median PFS was 4.0 months vs 3.7 months respectively.
Encouraging Early Data Of Atezolizumab/Bevacizumab Leads To Comparative Phase III Study
The phase Ib study of the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) compared to Tecentriq alone, in patients with unresectable Hepatocellular Carcinoma (HCC) has shown significant activity and tolerable toxicity. At the 12.4-month follow-up, the combination had an objective response rate of 36% and 12% of the patients showed a complete response to the treatment. Also, progression-free survival was 7.3 months. The combination reduced the risk of disease progression or death by 45% compared with Tecentriq alone. The team concluded that the combination of Tecentriq and Avastin is superior to Tecentriq alone.
When First-Line HCC Rx Fails, What Comes Next?
Sorafenib is considered by many doctors to be the front-line treatment for Hepatocellular Carcinoma (HCC). Now, clinicians are focusing on possible second-line treatment options. Recently, tyrosine kinase inhibitors and immune checkpoint inhibitors are being considered as viable second-line options. From the RESORCE and CheckMate 040 trials, Regorafenib (Stivarga) from Bayer, and nivolumab (Opdivo) from Bristol-Myers Squibb, have been shown as possible second-line options. The National Comprehensive Cancer Network (NCCN) guidelines were updated recently to include cabozantinib (Cabometyx) from Exelixis and lenvatinib (Lenvima) from Eisai as well.
New Genetic Treatment Targets Liver Cancer
Netherlands Cancer Institute and other medical specialists worked together to create a new treatment for liver cancer by inducing and exploiting vulnerabilities of cancer cells with the TP53 mutation. Liver cancer cells with TP53 mutation can speed up their degeneration and help eliminate cancer cells without impacting the growth of other normal cells. The researchers found CDC7 inhibitor can induce TP53 mutation of liver cancer cells and then quicken cell aging, while having no effects on healthy cells. Once the cancer cells have the mutation, the team discovered that sertraline, a medicine used for depression, in combination with mTOR inhibitor speed up the death of aging cells.
Eisai’s Hepatocellular Carcinoma Treatment Lenvima To Get Insurance Benefit
The Korean government will now grant insurance benefit to Eisai’s Lenvima (Lenvatinib) as a first-line treatment for unresectable advanced Hepatocellular Carcinoma (HCC). Patients with inoperable HCC or have stage III or higher, will now be reimbursed when using Lenvima as a monotherapy. This decision was based on the phase 3 clinical trial REFLECT study2 proving the treatment improved progression-free survival compared to Nexavar. The REFLECT trial on Lenvima evaluated the efficacy and safety of the drug, compared to Nexavar, in 954 patients. Lenvima showed 2 % complete remission, 38% partial remission, and 40.6% objective response rate.
Combination Of Atezolizumab And Bevacizumab Shows Early Efficacy In Unresectable HCC
According to 2 clinical trials, Atezolizumab (Tecentriq) in combination with bevacizumab (Avastin) induced objective responses in patients with unresectable Hepatocellular Carcinoma (HCC). The first trial involved 104 patients with no prior therapy. In the second study, investigators randomized 119 patients with untreated HCC to the same combination or to atezolizumab only. Clinically meaningful responses were seen in more than one-third of patients. A randomized trial showed that the combination reduced the risk of disease progression or death by 45% versus atezolizumab alone. 37 patients had stable disease, resulting in a disease control rate of 71%.
ESMO: Opdivo Study Author Looks For Bright Spots In First-Line Liver Cancer Failure
According to study author Thomas Yau, M.D., of the University of Hong Kong, the CheckMate 459 study of Opdivo did not fulfill its primary goal to help previously untreated liver cancer patients live longer. However, Opdivo beat Bayer's Nexavar, the current standard of care, when it came to complete response rate. Bristol had been hoping to challenge Nexavar, Bayer's long-standard therapy for Hepatocellular Carcinoma (HCC). Merck & Co. and Eisai's Lenvima won its first-line nod in August 2018, based on data showing Lenvima patients lived 13.6 months at the median, compared with Nexavar's 12.3 months.
Immunotherapy Improves Overall Survival For Hepatocellular Carcinoma
New data presented from the CheckMate 459 study found that nivolumab may serve as an effective therapy option for patients with advanced Hepatocellular Carcinoma (HCC). These results were presented at the ESMO Congress 2019 in Barcelona, Spain on September 27, 2019. The phase 3 CheckMate 459 study randomized 743 patients with advanced HCC to nivolumab or sorafenib as first-line treatment. The median OS was 16.4 months for nivolumab and 14.7 months for sorafenib. The results also showed that the overall response rate was 15% for nivolumab, including 14 patients with complete response, and 7% for sorafenib, in which 5 patients who had complete response.
A protein called Agrin has been discovered by scientists from the Agency for Science Technology and Research’s (A*Star) Institute of Molecular and Cell Biology (IMCB) who were working in collaboration with researchers from Nanyang Technological University’s (NTU) Lee Kong Chian School of Medicine. Researchers stated that Agrin “plays a vital role in the development and spread of cancer cells to secondary organ sites such as the lungs.” they also found that the inhibition of Agrin led to a reduction in tumor size and progression. Going forward, the team will be investigating how targeting Agrin can prevent blood vessel formation in liver and other tumors.
Can Sorafenib Be Topped In Advanced Hepatocellular Carcinoma?
According to the results of the randomized phase 3 CALGB 80802 clinical trial, sorafenib (Nexavar) plus doxorubicin (Adriamycin, Rubex) failed to improve survival in patients with advanced Hepatocellular Carcinoma (HCC) compared with sorafenib alone. The CALGB 80802 trial enrolled a total of 356 patients between 2010 and 2015 with locally advanced or metastatic HCC who did not receive systemic therapy. After a median follow-up of 36.1 months, the median overall survival was not statistically different between the sorafenib plus doxorubicin arm and sorafenib alone arm, 9.3 months vs 9.4 months, respectively. Also, the median progression-free survival was also not statistically different between the sorafenib plus doxorubicin arm and sorafenib alone arm, 4 months vs 3.7 months, respectively.
Auransa Inc. is developing AU-409, novel lead drug candidate being for the treatment of Hepatocellular Carcinoma (HCC). Auransa Inc. is an artificial intelligence (AI)-driven biotechnology company developing precision medicines. A team of researchers conducted in vivo studies to measure the antitumor activity of AU-409 in an orthotopic mouse model of HCC. The study results demonstrated promising antitumor activity. Tumor burden was reduced by 63%, and the treatment was well tolerated. The company expects to initiate first-in-human Phase 1 trials in the first half of 2020.
Upfront Rt Plus Nivolumab May Benefit Patients With Unresectable Hepatocellular Carcinoma
According to new data presented at the 2019 American Society for Therapeutic Radiation Oncology (ASTRO) Annual Meeting, Combining nivolumab with radiation therapy (RT) may improve objective responses and outcomes in patients with unresectable Hepatocellular Carcinoma (HCC). The researchers retrospectively identified 84 patients who received both nivolumab and RT. 25 patients were analyzed who received upfront RT prior to/overlapping with nivolumab initiation and 9 patients receiving salvage RT for longer than 4 weeks following nivolumab initiation. With a median follow-up 17.8 months, among responders, the median duration of response was 9.8 months.
Cabometyx Superior To Stivarga As Second-Line Liver Cancer Treatment
According to a study presented at the International Liver Cancer Association 2019 meeting, patients treated with Cabometyx as second-line therapy for patients with advanced Hepatocellular Carcinoma (HCC) who previously received Nexavar demonstrated superior progression-free survival and improved overall survival compared with Stivarga. In the CELESTIAL trial, cabozantinib improved median progression-free survival (5.2 vs. 1.9 months) and median overall survival (10.2 vs. 8 month) compared with placebo. The RESOURCE trials showed that cabozantinib improved progression-free survival (5.6 vs. 3.2 months) and numerically improved median overall survival (11.4 vs. 10.8 months) compared with regorafenib. “These results may support clinicians in making informed treatment decisions in order to deliver optimal care for their patients,” said Katie Kelley, MD, study investigator from the University of California, San Francisco.
On The Double: Immunotherapy Combinations In Liver Cancer
Radioembolization is a treatment in which tiny beads filled with radioactive material are delivered through the hepatic arteries that feed the tumor. The procedure blocks the blood supply and delivers radiation to the tumor while sparing normal tissue. This treatment lowers alpha-fetoprotein (AFP) levels. AFP is used as a protein tumor marker because it is elevated in 60% to 70% of people with liver cancer. CheckMate-040 was a clinical trial in which patients received the immunotherapy medication Opdivo (nivolumab) alone or with another type of immunotherapy drug, Yervoy (ipilimumab), with or without Cabometyx (cabozantinib), a tyrosine kinase inhibitor that blocks some of the cellular signals that can stimulate cancer cell growth.
Study Suggests New Metabolic Target For Liver Cancer
Research in a mouse model of liver cancer shows that disrupting a metabolic pathway in the liver in a way that creates a more “cancer-like” metabolism actually reduces tumor formation. The study, led by Eric Taylor, PhD, associate professor of biochemistry in the University of Iowa Carver College of Medicine, shows that the mitochondrial pyruvate carrier (MPC), a protein complex that is critical for glucose production in the liver, may represent a new target for preventing liver cancer. Taylor notes that these trials could provide important information about the safety and therapeutic contribution of altering MPC activity in people.
Dr. Michael Silverman, the Medical Director of Can-Fite BioPharma Ltd. presented “The Safety and Efficacy of Namodenoson in the Second Line Treatment of Advanced Hepatocellular Carcinoma (HCC) Patients with Underlying Child-Pugh B (CPB) Liver Cirrhosis: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study” at the International Liver Cancer Association (ILCA). While the Phase II study did not achieve its primary endpoint of overall survival (OS) in the whole population, superiority in OS was found in a sub-population. Median OS was 6.8 months for those treated with Namodenoson as compared to 4.3 months for those treated with placebo.
Celsion Corporation cosponsored a symposium focused on Hepatocellular Carcinoma (HCC) at the recent 13th Annual Conference of the International Liver Cancer Association (ILCA). The program was chaired by Ghassan Abou-Alfa, MD, MBA, Memorial Sloan Kettering Cancer Center and Professor. Dr. Abou-Alfa and Prof. Riccardo Lencioni, MD, FSIR, EBIR, have been involved in the development of Celsion’s lead product ThermoDox® for the treatment of HCC. “ThermoDox® is being studied as the first potential curative treatment for HCC in a large, randomized, multicenter Phase III trial,” said Prof. Lencioni.
AFP Response Could Assist In Cabozantinib Therapy Selection In HCC
According to findings of a sub-analysis of the phase III CELESTIAL trial, patients with advanced Hepatocellular Carcinoma (HCC) treated with cabozantinib (Cabometyx) had higher alpha-fetoprotein (AFP) response rates versus those treated with placebo. Robin Katie Kelley, MD, explained that the positive outcomes are worth noting and warrant future research into AFP response. Normally, elevated levels of serum AFP have indicated poor prognosis across all stages of HCC. Results of the CELESTIAL trial showed that cabozantinib significantly improved overall survival (OS) and progression-free survival (PFS) in patients with previously treated advanced HCC, independent of baseline AFP.
Safety Of Nivolumab/Ipilimumab Combination Confirmed For Advanced HCC
For those with advanced Hepatocellular Carcinoma (HCC), the CheckMate 040 study found that the combination of nivolumab (Opdivo), a PD-1 immune checkpoint inhibitor, with ipilimumab (Yervoy), a CTLA-4 checkpoint inhibitor, can be effective. Anthony B. El-Khoueiry, MD and his team compared a total of 148 patients with advanced HCC who had previously been treated with first-line therapy sorafenib (Nexavar). The phase III CheckMate 9DW study, soon to begin, will compare nivolumab and ipilimumab against the standard of care.
Comparing Sorafenib And Lenvatinib For The Frontline Treatment Of Advanced HCC
Both sorafenib (Nexavar) and lenvatinib (Lenvima) have been approved by the FDA for the treatment of patients with advanced Hepatocellular Carcinoma (HCC). Data from the REFLECT study showed that if a patient has a response with either agent, which could provide a survival of 22 months. Richard S. Finn, MD, professor of Clinical Medicine Division of Hematology/Oncology, UCLA David Geffen School of Medicine, University of California, Los Angeles, explains that he is more likely to give lenvatinib for bulky tumors or for patients with high alpha fetoprotein levels, or any other poor prognostic factors.
NANOBIOTIX has had positive findings from their phase I study evaluating first-in-class radio enhancer NBTXR3 activated by stereotactic body radiation (SBRT). The population for this study included 11 Hepatocellular Carcinoma (HCC) patients with a minimum life expectancy of three months that were unsuitable for local surgery or local treatment. SBRT is a well-tolerated alternative therapy, however the dose is limited by hepatic function. NBTXR3 also proved to remain within the injected tumor with no leakage to surrounding tissue. NBTXR3 is a first-in-class product designed to destroy tumors through physical cell death when activated by radiotherap.
Surgical Oncologist Highlights Treatment Approaches For HCC Ahead Of ISGIO
The treatment landscape for patients with advanced Hepatocellular Carcinoma (HCC) has advanced with several more options becoming available over the past few years. One option for patients with early-stage disease is ablation. This is where physicians can use a probe to freeze or burn out the cancer if it is in a favorable position, with either microwave or radiofrequency ablation. For patients with larger tumors, intra-arterial options are available. This is a treatment that uses beads that are embedded with either chemotherapy or radiation, such as yttrium-90 (Y-90). Y-90 and related treatments are able to attack the liver cancer directly.
Newly Discovered Biomarkers Suggest Who May Benefit From Liver Cancer Treatment
A team of researchers at Roswell Park Comprehensive Cancer Center found a biomarker that may help to determine which patients with Hepatocellular Carcinoma (HCC) will respond to treatment with Nexavar (sorafenib). The study investigator Dr. Renuka Iyer, section chief for gastrointestinal oncology at Roswell Park stated that “Only recently, in the last two or three years, we've gotten five or six more drugs to treat liver cancer. And so, when you have the options, you want to know which patients are going to benefit from the one you've always had, and which patients you may want to consider something else or consider a combination therapy.” The team collected blood samples from 30 patients. They discovered that patients with elevated levels of a subset of CD8+ cytotoxic T-cells (cells they kill cancer cells) had better outcomes.
Lenvima To Get Benefit As 1st-Line Treatment Of Hepatocellular Carcinoma
Lenvima (ingredient: lenvatinib) is a new liver cancer drug that may now benefit as a first-line treatment of Hepatocellular Carcinoma (HCC). The REFLECT trial on Lenvima evaluated the efficacy and safety of the drug, compared to Nexavar, in 954 patients in 20 countries with unresectable HCC. The Lenvima-treated group had 7.4-months in time to progression (TTP), whereas the Nexavar group had 3.7 months. Masatoshi Kudo, a professor of Kindai University was the chief researcher of the REFLECT study. The Health Insurance Review and Assessment Service (HIRA) stated that it would expand the reimbursement of Lenvima in the first-line treatment for patients with HCC who cannot undergo surgery or topical treatment.
Brit Invention Saves Transplant Patients' Lives By Keeping Livers 'Alive' Outside Body
A British invention, called the OrganOx, can keep human livers “alive” outside the body which are ready to be used for transplant. This device doubles the “shelf life” of a donor liver and reduces the risk of tissue damage, and so far, saving 500 patients facing death while waiting for a suitable donor. It was created by transplant experts, Prof Peter Friend and Prof Constantin-Coussios. Prof Joerg-Matthias Pollok, the head transplant surgeon at Royal Free said, “Having the machine buys us time to test the liver and make sure it is functioning well, which means there isn’t the rush to transplant often late at night or in the early hours. It takes the pressure off.”
Previous studies have shown significant improvement in overall survival (OS) when using doxorubicin plus sorafenib in the treatment of advanced hepatocellular cancer (HCC). In a randomized phase 3 clinical trial led by Alliance with 356 patients, median OS was 9.3 months in the doxorubicin plus sorafenib arm and 9.4 months in the sorafenib alone arm. The median progression-free survival (PFS) was 4 months in the doxorubicin plus sorafenib arm and 3.7 months in the sorafenib alone arm. The study began in February 2010 and was completed in May 2015, with OS as the primary endpoint.
Real-Time ctDNA Evaluation In Patients With Hepatocellular Carcinoma
A recently published study involved patients with Hepatocellular Carcinoma (HCC) undergoing circulating tumor DNA (ctDNA) testing. Over a 3-year period, 45 samples were collected from 35 patients. The median number of genetic alterations per samples was 3.5. A total of 122 unique alterations were identified. The team of researchers stated, “[ctDNA assessment] holds incredible promise for early detection of disease ... and evaluation of treatment response and mechanisms of resistance.”
Scientists Confirm Efficacy Of A Combination Therapy For Advanced Liver Cancer
Although sorafenib improves overall survival (OS)in patients with advanced Hepatocellular Carcinoma (HCC), researchers question what can increase its effectiveness. Scientists began to test whether a radiological procedure called transarterial chemoembolization (TACE) could increase patient survival. A team from Taiwan and Japan, led by Dr Victor Kok from Kuang Tien General Hospital Cancer Center and Asia University Taiwan, performed the first large, national-level, population-based cohort study. After tracking the data of 2112 Taiwanese patients, the team identified a 26% decrease in mortality when TACE was added to sorafenib treatment, compared with sorafenib treatment alone.
Laboratory For Advanced Medicine's Liver Cancer Test Gets FDA Breakthrough Tag
The FDA has granted breakthrough status to liver cancer liquid biopsy, created by Laboratory for Advanced Medicine (LAM). According to American Cancer Society, the existing blood test for liver cancer which detects alpha-fetoprotein (AFP), is flawed. The limitations of AFP and other screening techniques in early stage detection matter as the outcomes of liver cancer patients improve if the disease is treated when the tumor is small and localized. LAM’s approach is to use the DNA methylation alterations involved in tumorigenesis to detect cancer in its early stages. This method entails isolating cell-free DNA (cfDNA) from blood samples and analyzing it to identify DNA methylation patterns specific to HCC.
Tiziana Life Sciences plc is a biotechnology company focusing on the discovery and development of innovative therapeutics oncology. They currently have a Phase 2a study observing patients with unresectable Hepatocellular Carcinoma (HCC) and their Milciclib monotherapy. The study has shown that Milciclib was well tolerated with manageable toxicities and no recorded drug related deaths. The trial enrolled 28 patients in Italy, Greece and Israel. 14 out of 28 patients completed a 6-month duration of the trial. Both median time to progression (TTP) and progression-free survival (PFS) were 5.9 months. 18 of 28 patients showed Clinical Benefit Rate.
According to a study by researchers at UC San Francisco, patients on the waitlist for a liver transplant had significantly worse outcomes with public insurance compared to Kaiser Permanente or other private insurance. Liver transplant is the best treatment for Hepatocellular Carcinoma (HCC), though about 15% - 30% of candidates drop out from the waitlist within a year of being listed, primarily due to organ scarcity and cancer progression. African Americans have twice the HCC incidence rate as whites but are also the least likely to undergo potentially curative treatment. Neil Mehta, MD, UCSF Health gastroenterologist and associate professor of gastroenterology at UCSF, stated that “Public insurance should be recognized as a risk factor associated with waitlist dropout, and necessary steps should be implemented to mitigate the increased risk of dropout among these patients.”
Liver Cancer Outcomes Improving As Physicians Gain Experience With Nexavar
According to results from a 10-year retrospective study, increased physician experience in the management of Nexavar-related adverse events has led to longer treatment duration and improved overall survival rates in patients with Hepatocellular Carcinoma (HCC). Francesco Tovoli, MD, from the University of Bologna in Italy, and colleagues divided patients into two groups: 154 patients who received sorafenib between 2008 and 2012, and 184 patients treated between 2013 and 2017. All patient reported at least one adverse event after treatment initiation. Patients in the second time period group had higher rates of overall survival and longer median duration of treatment.
Potential Biomarker Identified For Treatment Response In Advanced Liver Cancer
Researchers have identified a potential biomarker that may indicate patient response to sorafenib which is a common chemotherapy treatment for liver cancer. Although regorafenib, ramucirumab, cabozantinib and lenvatinib are newly approved targeted therapies for the treatment of HCC, sorafenib remains the standard of care. The team observed elevated levels of CD8+ cytotoxic T-cells producing interferon type 2, which were associated with improved progression-free survival (PFS) and overall survival (OS). “Studying biomarkers that correlate with progression-free or overall survival can help reduce exposure to therapies that have an impact on a patient’s quality of life and survival,” lead author Yasmin Thanavala, PhD.
Baylor Awarded CPRIT Grants To Support Cancer Research
Baylor College of Medicine has been awarded more than $17 million by the Cancer Prevention & Research Institute of Texas (CPRIT) to support new cancer research and programs, core facilities and recruitment of new faculty. More than 70 grants were awarded to institutions across Texas, totaling close to $136 million to advance the fight against cancer. Dr. Hashem El-Serag, chair of department of medicine at Baylor, received one of two first-ever awards through CPRIT’s Collaborative Action Program for Liver Cancer, a new statewide initiative investing up to $18 million to reverse the rising rates of liver cancer. The $3 million grant to El-Serag will support the Texas Collaborative Center for Hepatocellular Cancer.
Can HCC Be Caught Early Using ctDNA?
According to preliminary results of a study, real-time evaluation of circulating tumor DNA (ctDNA) in patients with Hepatocellular Carcinoma (HCC) as a diagnostic tool appears feasible. CtDNA is a noninvasive, comprehensive tool that enables precision medicine for patients. It could be used to identify therapeutic targets and to monitor disease response to treatment, as well as to identify emerging resistance. Researchers evaluated patients with biliary tract cancer (BTC) who had undergone ctDNA testing. 44 samples were obtained from 35 patients, with more than 70% exhibiting stage 3 or 4 disease. HCC is commonly diagnosed late based on imaging findings alone, and it also recurs commonly.
Enzyme That Helps Protect Us From Stress Linked To Liver Cancer Growth
In a recent report, scientists show that the enzyme Nqo1, which is induced by stress to help reduce production of damaging free radicals, is also used by liver cancer to regulate two major cell proliferation pathways that enable the cancer to thrive. The fact that Nqo1 targets two -- rather than a single-- important downstream pathways, increases its value as a likely treatment target, explains Dr. Manali Dimri, MCG postdoctoral fellow. Blocking Nqo1 in turn, blocks the metabolic adaptation needed to enable liver cancer cell proliferation. Past research has also shown that high expression of Nqo1 has generally been correlated with increased tumor size.
Lipophilic Statins Associated With Significantly Reduced Liver Cancer Incidence And Mortality
Researchers from the Karolinska Institutet, Stockholm, Sweden and Harvard University, Boston, US, studied a nationwide Swedish registry of adults with viral hepatitis B or C to assess the relationship between lipophilic or hydrophilic statin use and Hepatocellular Carcinoma (HCC) incidence and mortality. They found an association between lipophilic statins and a significantly reduced incidence and mortality of HCC. Further research is needed to determine whether lipophilic statin therapy is feasible for prevention of HCC. There was no association between hydrophilic statins and reduced risk for HCC.
Aspirin Improves Liver Function After Embolization Of Hepatocellular Carcinoma
A retrospective review has found that aspirin therapy is associated with both improved liver function test results and survival after transarterial embolization (TAE) for Hepatocellular Carcinoma (HCC). The study was conducted by the Memorial Sloan Kettering Cancer Center in New York City and included 304 patients, of whom 42 took aspirin at the time of initial TAE. Aspirin use indicated no great difference in initial response rate. The median overall survival period after TAE for HCC measured longer for the cohort taking aspirin, 57 months verses 23 months. "Although the differences in liver function test results in the groups taking and not taking aspirin were small, standard biochemical liver function tests are insensitive to early cirrhotic changes," lead author F. Edward Boas said.
OU Surgeon Brings Robotic Liver Cancer Surgery To Oklahoma
Nelson Royall, M.D., a Tulsa-based OU Physicians surgeon was the first to bring major robotic liver surgery to Oklahoma. He is one of only a handful of robotic liver and pancreas surgeons in the United States and is the first in Oklahoma to use the robot to perform surgery for liver and pancreatic cancer. With robotic liver surgery, patients bleed less so they don't require blood products or transfusions. Royall explains that patients face a lower risk for complications, leave the hospital faster, and recover more quickly than those who undergo traditional open surgeries. Incisions are only five to eight millimeters. Three-dimensional imaging allows Royall to see where structures are in space. The robot also offers what is equivalent to X-ray vision - allowing him to see inside the liver and bile duct system.
Immunology researcher at the Roswell Park Comprehensive Cancer Center have uncovered a biomarker that may help explain why some patients respond better than others to a common chemotherapy for liver cancer. The 4-year study was led by Department of Immunology scientist Yasmin Thanavala, PhD. One finding showed that patients with a high ratio of CD4+ T-effector/T-regulatory cells prior to treatment showed significant improvement in both progression-free and overall survival. Thanavala and her team hope that their analysis of immune responses among patients receiving sorafenib can lead to more individualized treatment options and better overall outcomes for patients diagnosed with Hepatocellular Carcinoma (HCC).
City Hospital Introduces OPD Sessions For Liver Patients
Patel Hospital, in collaboration with Fortis Hospital, Delhi, has launched the super-specialty out-patient department (OPD) sessions for liver patients. The sessions would be conducted on second Friday of every month. Dr Varun Gupta, who has wide experience in pre-transplant and post-transplant care of liver patients, will examine the patients. Experts at the hospital note that this is the first time that any such OPD, comprising combined hepatology and liver transplant, has been introduced in the region. The success rate has improved, and the life expectancy has increased significantly in patients who undergo liver transplant. Liver can be taken from either a living or cadaveric donor.
Hepatocellular Carcinoma HCC Treatment Market Is Set To Experience Revolutionary Growth By 2027
In the past, Hepatocellular Carcinoma (HCC) generally occurred at an advanced stage of decompensated liver disease or cirrhosis. HCC is currently expected to be the third leading cause of death worldwide. technological advancements and the routine liver function tests are now resulting in the early detection of HCC. Monoclonal antibodies and other immunological treatments are known for their lesser side effects and better efficacy. The HCC treatment market has been segmented based on application, end use and geography. The global HCC treatment market is expected to grow in future due to increasing investment by multinational companies in the cancer research.
Research Shifting To Explore Combinations For Treatment Of Advanced HCC, Expert Says
Josep M. Llovet, MD believes that research is shifting, and single agents will become outdated. Single-agent tyrosine kinase inhibitors (TKIs) have been ingrained as standards of care treat patients with Hepatocellular Carcinoma (HCC). An example TKI that Llovet expects to be explored in combination therapies in the future is ramucirumab (Cyramza). Cyramza was approved by the FDA for the treatment of patients with HCC based on the results of the phase III REACH-2 trial (NCT02435433). Patients who received Cyramza also had a better progression free survival (PFS) rate compared with placebo. Llovet believes that the drug will now be explored in combinations with another TKI, a checkpoint inhibitor, or with a TGF-beta inhibitor in future clinical trials.
An Easier, Less Painful Way To Look Inside Your Liver
A liver biopsy can be ordered by your doctor to help solve a medical problem. Unfortunately, they are painful and can be inaccurate. Doctors now have a new approach called an endoscopic ultrasound liver biopsy. "We can target a needle biopsy very nicely directly into the liver and thereby minimizing potential risks of perforation or bleeding," said Dr. Ann M. Chen, gastroenterologist at Santa Clara Valley Medical Center. Longer tissue samples are taken from both lobes of the liver, increasing the likelihood of an accurate diagnosis to 90%. Santa Clara Valley Medical is one 10 ten locations across the country that performs the endoscopic ultrasound liver biopsy.
Can-Fite BioPharma Ltd., a biotechnology company, announced that a supply of Namodenoson has been manufactured and is ready for use in the treatment of advanced liver cancer patients under compassionate use at the Rabin Medical Center in Israel. Compassionate use allows doctors and patients the option of early access to investigational new drugs, when a patient who is facing serious illness has exhausted all available treatment options. Namodenoson is a small oral drug that binds with the A3 adenosine receptor (A3AR). Namodenoson was found to increase overall survival in HCC patients. The FDA has granted Namodenoson both Orphan Drug and Fast Track status, allowing for accelerated approval based on the unmet need in the treatment of advanced liver cancer.
City Of Hope First In US To Offer This Experimental Drug For Liver Cancer Patients
City of Hope is the first in the United States to open an immunotherapy clinical trial for liver cancer which has the potential to transform treatment into an outpatient procedure. A team of scientists at the City of Hope have started a phase 1/2 research clinical trial that engineers a person's own immune T cells to target an alpha fetoprotein (AFP)-peptide/HLA-A2 complex - a small protein/antigen highly expressed in Hepatocellular Carcinoma. City of Hope is the first of five institutions in the United States to test Eureka Therapeutic's experimental ET140202 ARTEMIS™ T cell therapy on patients who are AFP-positive and HLA-A2 positive. ET140202 T cells recognize and bind to the AFP peptide/HLA-A2 complex, become activated and kill the liver tumor cells. ET140202 T cell therapy was first tested in China in a first-in-human, proof-of-concept study.
OPTIMA Phase III Study with ThermoDox® plus RFA (radiofrequency ablation) in patients with Hepatocellular Carcinoma (HCC) will be submitted for interim analysis. The first interim analysis will be conducted by the Independent Data Monitoring Committee (iDMC). The OPTIMA Study was fully enrolled in August 2018 with 556 subjects from 65 clinical sites in 14 countries. The design of the OPTIMA Study is based on the Company’s HEAT Study, in which a subgroup analysis of 285 subjects received a single ThermoDox® administration in combination with a 45 minute or more RFA procedure in patients with a single lesion of 3-7 cm in size. ThermoDox demonstrated a median survival of more than 7 ½ years and a survival benefit of more than 2 years over the control group.
SFA Therapeutics, Inc. has filed an FDA application requesting Orphan Drug Designation (ODD) for SFA001, the company’s novel microbiome-based treatment for human Hepatocellular Carcinoma (HCC). In animal models, SFA001 has been shown to block the progression of hepatitis B to HCC and has been shown to treat HCC with a non-chemotoxic mechanism in two forms of human HCC. SFA Therapeutics, Inc. is a bio-pharmaceutical company focused on new human-microbiome-based advancements in the treatment of inflammatory diseases. “In seeking Orphan Drug Designation (ODD) for this patented new human-microbiome-based drug, we are asking FDA to grant special status to the treatment of the most prevalent form of liver cancer. ODD status would provide significant drug development and tax advantages as well as expanded market exclusivity,” stated Ira Spector, PhD, SFA Therapeutics’ CEO.
Eureka Therapeutics, Inc announced a Phase 1/2 clinical trial of ET140202 ARTEMIS™ T-Cell therapy in liver cancer at City of Hope for the treatment of advanced Hepatocellular Carcinoma (HCC). Eureka Therapeutics, Inc. is a clinical stage biopharmaceutical company which is in the process of developing T-cell therapies that harness the power of the immune system. ET140202 utilizes Eureka’s proprietary ARTEMIS™ antibody T-cell receptor (AbTCR) platform engineered with a proprietary human TCR-mimic (TCRm) antibody to target an alpha fetoprotein (AFP)-peptide/HLA-A2 complex on HCC cancer cells. The trial is enrolling patients who have metastatic or locally advanced, inoperable liver cancer and have progressed or have not been able to tolerate at least one line of treatment for their disease.
New Curtin Scholarship To Help Improve Outlook For Liver Cancer Patients
Curtin University and the Lions Cancer Institute Inc. are offering a new PhD scholarship the scholarship hopes to improve the outcomes of people living with liver cancer around the world. The recipient of the scholarship will get the opportunity to work with Associate Professor Nina Tirnitz-Parker from CHIRI and Curtin’s School of Pharmacy and Biomedical Sciences and conduct innovative research dedicated to the prevention and treatment of liver cancer. Curtin University and the Lions Cancer Institute Inc will fund a full PhD scholarship for up to 3.5 years and will be available to domestic PhD students in Australia.
Pexa-Vec/Nexavar Combination Fails Phase III Trial In Liver Cancer
SillaJen and collaboration partner Transgene, have shown results of their failed lead-pipeline candidate Pexa-Vec (pexastimogene devacirepvec). In the recent Phase III trial, they hoped to assess a combination of the oncolytic virus and the Bayer/Amgen cancer drug Nexavar® (sorafenib) in liver cancer. Pexa-Vec, is a Wyeth strain oncolytic vaccinia virus armed with a granulocyte-macrophage colony stimulating factor (GM-CSF) gene designed to promote an anti-tumor immune response. Pexa-Vec was designed to fight cancer by infecting and selectively replicating in cancer cells, reducing the blood supply to tumors through infection and activating the body’s own immune system to recognize and kill tumor cells. SillaJen said in a regulatory filing that it was advised to halt patient enrollment in the Phase III PHOCUS trial (NCT02562755).
Expert Discusses Sequencing TKI Strategies In Hepatocellular Carcinoma
Now that doctors have 5 tyrosine kinase inhibitors (TKIs) approved for the treatment of patients with Hepatocellular Carcinoma (HCC), they are now left with the task of figuring out the correct sequence in which to use them. “TKIs are the first choice of therapy, but within that context, the only TKIs that are applicable in the first-line setting are lenvatinib and sorafenib,” said Ghassan Abou-Alfa, MD. Sorafenib (Nexavar) and lenvatinib (Lenvima) are the only 2 FDA-approved TKIs for frontline treatment in HCC. According to the REFLECT trial, lenvatinib showed non-inferiority to sorafenib with a median OS of 13.6 months and 12.3 months with sorafenib. Second-line options following progression on either lenvatinib or sorafenib include 5 TKIs and 2 checkpoint inhibitors.
Aspirin Improves Liver Function After Embolization Of Hepatocellular Carcinoma
According to a recent retrospective review, Aspirin therapy is associated with both improved liver function test results and survival after transarterial embolization (TAE) for Hepatocellular Carcinoma (HCC). The review, led by F. Edward Boas at Memorial Sloan Kettering Cancer Center in New York City, included 304 patients. 42 patients taking aspirin. Boas and his team kept track of the patients' bilirubin levels as an indicator. Boas acknowledged that a confounding variable may account for the improved survival among patients taking aspirin.
FDA Grants Breakthrough Therapy Status To Lenvima-Keytruda Combo For Advanced Liver Cancer
The U.S. Food and Drug Administration (FDA) has granted the designation of breakthrough therapy to Keytruda (pembrolizumab) in combination with Lenvima (lenvatinib) as a first-line treatment for patients with Hepatocellular Carcinoma (HCC). The designation of breakthrough therapy is awarded to medications that provide significant advantages over other currently available options. Keytruda is an anti-PD-1 checkpoint blockade immunotherapy developed by Merck. Lenvima is an oral kinase inhibitor, developed by Eisai. The FDA’s decision to grant this designation for HCC was based on the latest findings from the Phase 1b KEYNOTE-524/Study 116 (NCT03006926). All participants in the study were treated with Keytruda administered intravenously at a dose of 200 mg every three weeks and with Lenvima administered orally at a daily dose of 8 mg or 12 mg.
Researchers recommend TheraSphere for personalized treatment for Hepatocellular Carcinoma (HCC). Prof. Etienne Garin, nuclear medicine physician, Cancer Centre Eugène Marquis, Rennes, France conducted the Dosisphere phase II dosimetry trial compared the efficacy of TheraSphere in 56 patients. His team used a personalized approach with Simplicit90Y dosimetry software versus standard dosimetry. Higher response rates of 71 percent were seen in the personalized prospective dosimetry arm versus 36 percent with standard dosimetry.
Chronic Cannabis Use And Liver Cancer
Researchers University of Arkansas for Medical Science investigated the effects of cannabis compound, cannabidiol, on the livers of mice. According to the results, people who regularly consume the compound have greater chances of developing liver cancer. It suggests that even though cannabidiol is good for relieving pain in comparison to painkillers, it is harmful to liver. hepatitis C patients who consumed cannabis showed more scars on the liver tissues than those who didn’t consume it. Scientists found that the mice they gave larger doses of CBD to had signs of liver toxicity within a day.
QSC Launches 'Protect Yourself' Campaign To Raise Awareness On Liver Cancer
Qatar Cancer Society (QCS) has created the “Protect Yourself” campaign to raise awareness of liver cancer. Nour Mekkia, Health Educator at QCS, explains that liver cancer is more common in males and the elderly. She defines liver cancer as an uncontrolled growth of abnormal cells in the liver, which is primary liver cancer. When abnormal cells spread to the liver from another part of the body, that is known as metastatic liver cancer. Risk factors include type 2 diabetes, obesity, and occupational exposure to chemicals. “Chronic viral hepatitis B & C these infections can lead to cirrhosis and liver cancer,” said Mekkia.
Ensure A Healthy Liver By Including And Avoiding These Foods In Your Diet
Our daily diets play an important role in our general health and the health of our liver. Some foods improve liver health, while others have adverse effects. Coffee is considered one of the best beverages to consume if you want to have a healthy liver. According to several studies, drinking coffee lowers the risk of liver diseases and cancers, and can also help to treat the diseases and reduce inflammation in the liver. Garlic is also a great food item to add to your diet if you want a healthy liver. Another study shows that the consumption of garlic can help in reducing weight and fat content. All members of the berry family, i.e., blueberries, blackberries, strawberries, are rich in antioxidants, which make them a preferred choice of food to treat many health issues. Antioxidants play an important role in keeping us healthy. Studies also suggest that berries help strengthen the immune system.
Specific Peptide-Enhanced Affinity Receptor T Cells For Hepatocellular Carcinoma
AFPc³³²T in Advanced Hepatocellular Carcinoma (HCC) is a phase 1, open-label, first-in-human clinical trial to evaluate the safety and anti-tumor activity. Lipika Goyal, MD, a gastrointestinal medical oncologist specializing in hepatobiliary cancers at Massachusetts General Hospital Cancer Center and one of the trial’s principal investigators explains, “We use the patient’s own T cells and modify them to recognize the cancer as foreign.” Researchers are currently enrolling patients into the study; eligible participants will have their T cells collected and sent to the manufacturer for genetic modification. So far, two patients have been safely treated.
BTG is a global healthcare company, creating personalized treatment for hepatocellular carcinoma (HCC) with TheraSphere™. Data from their recent study, Dosisphere phase II, has been published. This study compared the efficacy of TheraSphere in 56 patients with at least one lesion greater than 7cm, using a personalized approach with Simplicit90Y dosimetry software vs standard dosimetry. Dosimetry refers to dose history and calculation of an absorbed dose in tissue. Higher response rates of 71% were seen in the personalized prospective dosimetry arm vs 36% with standard dosimetry. "The future for radioembolization is personalized dosimetry," said Prof Garin, Principal Investigator of the study.
Liver Cancer Symptoms: The Sign In Your Eyes You Could Have The Deadly Condition
The early stages of liver cancer tend to have vague symptoms. One sign to be wary of is yellow eyes, according to Cancer Research UK. Yellow eyes are a sign of jaundice, which is a condition that can also cause the skin to turn yellow. The cancer charity explains: “When you have jaundice your wee (urine) is darker than normal and your poo (stools or feces) is lighter in color.” Other symptoms include unintentional weight loss, loss of appetite, pain or swelling in the abdomen, and itchy skin. The symptoms of liver cancer usually don’t appear until the cancer is at an advanced stage, which makes recognizing symptoms even more important. Treatment for liver cancer depends on how advanced the cancer is and if it’s spread to other areas of the body. Chemotherapy, radiotherapy and radio frequency ablation are some of the treatment options for liver cancer.FDA Grants Breakthrough Therapy Designation To Keytruda-Lenvima Combination For Hepatocellular Carcinoma
The FDA recently granted therapy designation to pembrolizumab in combination with lenvatinib as first-line treatment for patients with advanced unresectable hepatocellular carcinoma (HCC). “As part of our ongoing collaboration with Eisai, we are committed to evaluating the potential of Keytruda plus Lenvima across a number of different types of cancer,” Jonathan Cheng, MD, vice president for oncology clinical research at Merck Research Laboratories. This decision was based on interim results from the phase 1B KEYNOTE-524/Study 116.
Expert Discusses Impact Of Survival Outcomes In KEYNOTE-240 Trial For Advanced HCC
A recent study called the KEYNOTE-240 (NCT02702401) trial showed a survival benefit in the second-line hepatocellular carcinoma (HCC) setting, but it did not meet its primary endpoints. The phase III study was randomized, and placebo controlled. It investigated pembrolizumab (Keytruda) in patients with advanced HCC who were previously treated with sorafenib (Nexavar). 413 patients were randomized 2:1 to receive either pembrolizumab plus best supportive care or placebo. After a median follow-up of 13.8 months, both progression-free survival (PFS) and overall survival (OS), the co-primary endpoints of this study, were improved, but these findings did not meet statistical significance.
Nivolumab (Opdivo) monotherapy is currently indicated for the treatment of patients with hepatocellular carcinoma (HCC), who were previously treated with the targeted therapy sorafenib. Researchers have observed clinically meaningful responses and an acceptable safety profile in the assessment of safety and efficacy of nivolumab in combination with ipilimumab (Yervoy). During the CheckMate 040 trial, nivolumab monotherapy, seven patients achieved a complete response with a median duration of response of 17 months. Only 5% of patients had a treatment-related adverse event that led to treatment discontinuation.
Tiziana Life Sciences is a biotechnology company focusing on the discovery and development of innovative therapeutics for inflammation and oncology indications. Recently, positive results were reported for their Phase 2a trial of Milciclib as a monotherapy in patients with advanced hepatocellular carcinoma (HCC). Among the 28 evaluable patients, 14 completed the 6-month duration study. 9 out of the 14 patients requested to continue the treatment after completing the 6-month trial period. Overall, treatment with Milciclib was well-tolerated. Secondary endpoints of efficacy including progression-free survival (PFS) and time to progression (TTP) are currently being evaluated.
New Biomarker-Guided Strategy Has Potential For Liver Cancer Treatment
A study at The University of Texas MD Anderson Cancer Center discovered a cellular pathway tied to cancer. This pathway may be beneficial in reducing side effects and extending duration of immunotherapy in some patients with hepatocellular carcinoma (HCC). Researchers looked at a cellular pathway formed when a protein known as interleukin-6 (IL-6) activates an enzyme called Janus kinase 1 (JAK1). The IL-6/JAK1 pathway is often observed in tumors and may play a role in cancer evasion by regulating cellular function in programmed death ligand 1 (PD-L1), a type of protein known to suppress the immune system. The study also pointed to a potential benefit for lessening immunotherapy side effects, which sometimes can shorten the amount of time patients can stay on treatment.
Combinations May Be The Future Of Liver Cancer Treatment
In the past 15 years, the treatment landscape for hepatocellular carcinoma (HCC) has shifted dramatically. The next phase of innovation, according to Dr. Josep M. Llovet, a professor of medicine and the director of the Liver Cancer Program at Mount Sinai Hospital in New York City is likely to involve combinations of these drugs to better outcomes for patients. The management of the advanced stages of HCC has five main drugs: Sorafenib (Nexavar) and lenvatinib (Lenvima) in the front line, and in the second line we have regorafenib (Stivarga), cabozantinib (Cabometyx) and ramucirumab (Cyramza).
WVU Performs First Robotic Liver Surgery
Surgeons at the West Virginia University (WVU) Cancer Institute have performed a robotic-assisted surgery to implant a hepatic artery. This was the first time this surgery has been performed robotically in the state. Hepatic artery infusion pumps allow oncologists to deliver chemotherapy directly to the liver through the hepatic artery, the main blood supply to the liver. The pump is filled every two weeks and continuously delivers chemotherapy to the liver. Dr. Emily Groves and Dr. Brian Boone performed the surgery.
Can Green Tea Prevent Liver Cancer?
Fung Lung Chung, PhD and associate Professor of Oncology Aiwu Ruth He, MD, PhD, at Georgetown are testing the power of an extract found in the green tea. Animal studies as well as research in human liver biopsies have shown that Chung’s compound, TE, can stop cancer transition if the liver produces a chemical that can cause DNA damage TE minimizes the DNA damage. The current trial is enrolling people with liver cirrhosis who are at substantial risk of developing tumors. The trial is being led by Ruth He and is being conducted with MedStar and the University of Puerto Rico.
Neoadjuvant RT Boosts Survival In Liver Cancer With PVTT
Chinese researchers have discovered that Neoadjuvant radiotherapy improved survival rates in hepatocellular cancer (HCC) patients with portal vein tumor thrombus (PVTT). Results from a randomized, multicenter, controlled trial at three hospitals in China show overall survival rates to be 89.0% at 6 months, 75.2% at 12 months, 43.9% at 18 months, and 27.4% at 24 months. Shuqun Cheng, MD, of Naval Military Medical University in Shanghai, and colleagues recruited 164 patients with resectable HCC and PVTT. Overall response rate in radiotherapy recipients was 20.7% (17 patients); stable disease was seen in 70.7% (58 patients).
New Legislation Allocates Funding For Liver And Bile Duct Cancer Research
According the Centers for Disease Control and Prevention, Hawaii has one of the highest rates of liver and bile duct cancer in the nation. About 200 people in Hawaii die from liver and bile duct cancer every year. Dr. Herbert Yu, program director, cancer epidemiology program, UH Cancer Center said, “We want to study together to see if there's any difference or interaction between the two so give us more complete picture of the disease.” The legislation provides researchers $350,000 for a year.
When To Use Direct-Acting Antivirals In Hepatocellular Carcinoma
Direct-acting antiviral agents (DAAs) have replaced interferon-based treatments for hepatitis C virus (HCV) and offer several advantages. A few early reports associated first-generation DAAs with an increased risk for new and recurrent Hepatocellular Carcinoma (HCC). Multiple studies have since shown that DAAs significantly reduce the risk for new HCC in patients with HCV. A recent review of 11 retrospective studies that examined HCC incidence including over 30,000 patients treated with DAA therapy showed an approximate 70% reduction in HCC risk. Amit Singal, MD, medical director of the Liver Tumor Program, clinical chief of hepatology, and an associate professor with UT Southwestern Medical Center in Dallas, Texas, was lead investigator.
Ramucirumab Effective Irrespective Of Prior TACE In Advanced HCC With Elevated AFP
According to an analysis of REACH/REACH-2, Ramucirumab improves survival for patients with advanced hepatocellular carcinoma (HCC) and elevated alpha-fetoprotein (AFP) regardless of prior transarterial chemoembolization (TACE) treatment. Although TACE has been shown to prolong overall survival (OS), patients have high rates of recurrence and require subsequent systemic therapy. Patients with advanced HCC with progression or intolerance to sorafenib, were randomized in REACH (1:1) or REACH-2 (2:1). Dr Meyer reported that the analysis found efficacy of ramucirumab to be similar between TACE and non-TACE subgroups. Ramucirumab treatment also improved progression free survival (PFS) compared to placebo in patients who received prior TACE.
Expert Considers First- And Second-Line Liver Cancer Treatment Options In 2 HCC Case Studies
Aiwu Ruth He, MD, PhD, discussed with a group of physicians the considerations she makes when deciding on treatment for patients with hepatocellular carcinoma (HCC). Dr He is a medical oncologist at Medstar Georgetown University Hospital. She discussed two patient scenarios. The first was an otherwise healthy, 77-year-old Caucasian woman with a history of alcohol use, who presented to her primary care physician complaining of abdominal pain and fatigue. Lenvatinib (Lenvima) 12 mg twice a day was initiated. The second was a 63-year-old man with chronic hepatitis C (HCV) infection. He was started on sorafenib 400 mg every other day.
Immunotherapy is a treatment that uses certain parts of a person’s immune system to fight diseases, such as cancer. Immunotherapy can be done in two different ways. The first option is to stimulate the patient’s own immune system to work harder or smarter to attack cancer cells. The second is to give the patient immune system components such as manmade-immune system proteins. It is important for the immune system to tell the difference between normal cells and foreign cells. To do this, it uses ‘checkpoints,’ which are molecules on certain immune cells that need to be activated to start an immune response.
Hepatocellular Carcinoma: Switching to Systemic Therapy
Josep Llovet, MD, PhD explains that the number of treatments a patient should receive, or when they should switch to systemic therapies is always a question. 2 or 3 treatments is the median number of treatments in trials. We now have 6 potential treatments that are effective. Physicians are more comfortable switching to systemic therapy because they have the frontline treatment of lenvatinib/sorafenib, then a second-line treatment of regorafenib, or checkpoint inhibitors. Arndt Vogel, MD, PhD discusses different triggers for systemic therapies. Vogel explains that therapies such as TACE in Hepatocellular Carcinoma (HCC) can also damage the liver and deteriorate liver function.
Kansas City Man Credits Innovative Doctor And TV Ad For Saving His Life
Willie Woods, 72, and his oncologist at St. Lukes, Dr. Addison Tolentino, met two years ago. After seeing an advertisement for Opdivo, though intended for use on lung cancer, Woods decided to take a chance and see if it would have positive results for his liver cancer. When Woods asked Tolentino about the possibility, Tolentino replied, “Let’s go for it.” Statistics show that only 18% of people survive Woods’ type of liver cancer five years after a diagnosis. Since Woods started the drug, it’s been approved for liver cancer and several other cancers as well.
Blue Faery: The Adrienne Wilson Liver Cancer Association provides patients with hepatocellular carcinoma (HCC) and their caregivers a wide range of resources. Patient advocacy organizations have grown from the need for patients to share practical knowledge. Patient-focused forums can help patients connect with other patients, patient groups, and current research programs and clinical trials. Blue Faery’s ultimate goal is to save people from HCC through research, education, and advocacy. The online community forum enables HCC patients and their caregivers to share their stories and receive peer support.
New Online Resources Provide Support To The Liver Cancer Community
Blue Faery: The Adrienne Wilson Liver Cancer Association was founded by Andrea Wilson after the loss of her 15-year-old sister Adrienne to Hepatocellular Carcinoma (HCC). Andrea discussed Blue Faery’s new initiatives at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting. Blue Faery hosts an online forum, Blue Faery Liver Cancer Community, for patients and caregivers. In an interview, Andrea states, “My first piece of advice is to get a second opinion and, in many cases, a third opinion. No matter how much you love your doctor, always get a second opinion.”
Asia-Pacific Hepatocellular Carcinoma (AHCC) Trials Group Meeting
The 3rd annual Symposium of the Singapore Liver Cancer Consortium (SLCC) was hosted by the Asia-Pacific Hepatocellular Carcinoma (AHCC) Trials Group. Members of the AHCC Trials Group, other HCC researchers attended. Prof Pierce Chow, Senior Consultant, Division of Surgical Oncology, National Cancer Centre Singapore (NCCS) stated, "In pursuance of our aims to bring about better clinical outcomes for patients with HCC, the AHCC Trials Group is constantly exploring collaborations with investigators from both academic research institutes and industry partners.” The AHCC trials group has recently initiated 2 prospective studies on HCC in the Asia-Pacific (AHCC protocols 07 and 08).
Bristol-Myers Squibb's Opdivo Misses Its Shot At Earlier Use In Liver Cancer
Opdivo, developed by Bristol-Myers Squibb, already has an FDA approval in liver cancer patients who have been treated with Bayer’s Nexavar for Hepatocellular Carcinoma (HCC). A recent study shows that drug failed to beat Nexavar at extending patients’ lives in a phase 3 study called CheckMate-459. The survival data didn’t meet the statistical significance bar in the trial. The CheckMate-040 trial also shows that the tumor response rate it of 14.3%, isn’t that much different from the 17% Keytruda posted in its phase 2 Keynote-224 study.
Race-Matched Liver Transplants Improve Survival For Black Patients With Hepatocellular Carcinoma
Dr. T. Clark Gamblin, chief of surgical oncology at Medical College of Wisconsin, and colleagues utilized the United Network for Organ Sharing (UNOS) Organ Procurement and Transplant Network database to obtain records for adults who underwent liver transplantation. This team has a strong interest in primary liver cancer. Liver transplant is one treatment option for patients with early-stage disease. They identified 1,384 black patients, of whom 325 (23.5%) underwent race-matched transplant. Patients who received race-matched transplant achieved a median overall survival (OS) of 135 months vs. 78 months for those with non-race-matched transplants.
Arbutus Receives Regulatory Clearance To Initiate Phase 1a/1b Clinical Trial Of AB-729
Arbutus Biopharma Corporation has been approved to initiate a Phase 1a/1b clinical trial of AB-729. Arbutus is an industry-leading Hepatitis B Virus (HBV) therapeutic solutions. AB-729 is an RNA interference (RNAi) therapeutic targeted to hepatocytes. It has been shown to reduce viral antigens and inhibit HBV proliferation. AB-506 is an oral HBV capsid inhibitor. HBV which also inhibits proliferation. Before receiving approval, Arbutus was required to complete a three- and six-month toxicology study.
Stem Cells Obtained From Menstrual Blood May Epigenetically Inhibit Liver Cancer
Menstruation is a normal and natural part of human life which signifies a healthy reproductive system and a women’s ability to bear children. However, it has been viewed in a negative light and not always appreciated for its real purpose. Menstrual blood and tissue are valuable resources of mesenchymal stem cells (MSCs). In a recent study, researchers tested menstrual derived MSCs (MenSCs) on a certain type of liver cancer to determine if they could inhibit tumor cell growth. The results revealed that these stem cells indeed induced had an anticancer effect. these stem cells are readily available and can be isolated non-invasively from voluntary female donors without invoking ethical concern.
Poor Oral Health May Up Liver Cancer Risk
A recent study shows that poor oral health is associated with a 75% increased risk of Hepatocellular Carcinoma (HCC). Haydee WT Jordao, from the Queen's University Belfast, and lead author of the study, along with his team analyzed over 469,000 people in the UK. They investigated the association between oral health conditions and the risk of several gastrointestinal cancers, including liver, colon, rectum and pancreatic cancer. Participants with poor oral health were more likely to be younger, female, living in deprived socioeconomic areas and consumed less than two portions of fruit and vegetables per day. When the liver is affected by diseases, such as hepatitis, cirrhosis or cancer, its function will decline and bacteria will survive for longer and therefore have the potential to cause more harm, explains Jordao.
Lumping All Hispanic Americans Together Masks The Differences In Cancer Outcomes
A San Diego State University (SDSU) study is among the first to describe trends in cancer mortality by specific Hispanic groups. There are some significant differences in food habits, cultural mores, and lifestyles among Cubans, Mexicans, Puerto Ricans, and Central and South Americans in the U.S. The study came about because a third-generation Mexican-American graduate student researcher at SDSU, Steven Zamora, wanted to understand what his own risks were. His study shows that Mexican American and Puerto Rican American males were dying at twice the rate of non-Hispanic whites from stomach and liver cancers.
NASH Rapidly Overtaking Hepatitis C As Cause Of Liver Cancer
Nonalcoholic steatohepatitis (NASH) is rapidly gaining hepatitis C virus (HCV) infection as the leading contributor to liver cancer in the United States. Based on research results, the prevalence of HCV has been in steady decline since 2005. Researchers have forecast a decline to 1.06 million cases by 2025, from the 3.22 million cases in 2005. In terms of effect on the prevalence of Hepatocellular Carcinoma (HCC), the modeling suggested cases of HCV-related liver cancer were predicted to peak at around 29,000 cases in 2025. A higher proportion of patients with NASH develop cirrhosis. The probability of developing HCC is higher in patients with HCV.
Individual Approach May Help To Determine Second-Line Treatment Options In Liver Cancer
Until 2018, patients with Hepatocellular Carcinoma (HCC) only had one front-line treatment option: Nexavar(sorafenib). Since Nexavar was approved in 2007, no positive trials were announced until 2017. August 2018, the FDA approved Lenvima (lenvatinib) for the front-line treatment of patients with unresectable HCC based on results from the phase 3 REFLECT trial. The results from the trial showed a median overall survival of 13.6 months in the Lenvima arm compared with 12.3 months in the Nexavar arm. The median progression-free survival was 7.4 months in those who received Lenvima versus 3.7 months in patients treated with Nexavar.
Hepatocellular Carcinoma HCC Treatment Market Pegged For Robust Expansion During 2016-2026
Hepatocellular Carcinoma (HCC) is currently expected to be the third leading cause of death worldwide. The increase in incidences of HCC associated with hepatitis C virus are expected to grow. HCV infection is the principal cause of HCC in North America, Europe, and Japan. Inventions in technologies for cancer treatment procedures are expected to launch into the market. HCC treatments include chemotherapy and local ablation therapy. Monoclonal antibodies and other immunological treatments are generally known for their lesser side effects and better efficacy.
Sustained Virologic Response In Patients With Chronic Hepatitis C And Liver Cancer
According to a systematic review and meta-analysis, efforts are needed to aggressively screen, diagnose, and treat Hepatocellular Carcinoma (HCC). Patients with chronic hepatitis C and HCC may be less likely to achieve cure status than those without HCC. Questions still remain about the effect of HCC on response to interferon-free direct-acting antiviral (DAA) therapy for patients with chronic hepatitis C. Researchers investigated the effect of DAA therapy on sustained virologic response (SVR) among 3341 patients with chronic hepatitis C and HCC and 35,701 patients with chronic hepatitis C but without HCC from 49 studies conducted in 15 countries. Overall, they found that SVR rates were lower in patients having chronic hepatitis C with HCC compared with patients diagnosed without HCC.
Selective Effect Signal On Liver Cancer Tissue In Phase IA Study With MIV-818
Data from the first six patients with advanced cancer in the liver treated with increasing MIV-818 doses has been published. MIV-818 is developed by Medivir AB. MIV-818 is a pro-drug designed to selectively treat liver cancers and to minimize side effects. Scientist believe that it has the potential to become the first liver-targeted, orally administered drug to benefit patients with HCC. The phase I/II study of MIV-818 consists of three parts. Based on the positive results from the first six patients, Medivir has decided to initiate the phase IB in which the dose is escalated in cohorts of three patients.
Regular Aspirin Use And Risk Of Hepatocellular Carcinoma And Epithelial Ovarian Cancer
According to Tracey G. Simon, MD, MPH, of Massachusetts General Hospital, Harvard Medical School, and colleagues the use of at least two standard-dose aspirin tablets per week was associated with a significant reduction in the risk for Hepatocellular Carcinoma (HCC). The study involved data from 133,371 participants. The investigators reported on aspirin use, frequency, dosage, and duration of use. The investigators concluded: “This study suggests that regular, long-term aspirin use is associated with a dose-dependent reduction in [Hepatocellular Carcinoma] risk, which is apparent after 5 or more years of use.”
Bayer And China’s Cstone Pharmaceuticals Team Up On Cancer Program
CStone Pharmaceuticals and Bayer are working together to evaluate the safety and efficacy of a checkpoint inhibitor with a multi-kinase inhibitor for the treatment of multiple cancers. They will pair CStone’s CS1001 with Bayer’s regorafenib, an oral multi-kinase inhibitor that targets VEGFR, FGFR, CSF1R and other receptors. CStone will be the study sponsor and Bayer will provide regorafenib throughout the clinical trial program. Bayer’s Regorafenib, known as Stivarga in the United States is approved in more than 80 countries for the second-line treatment of advanced hepatocellular (HCC).
Researchers report that there is a “strikingly low adherence” to clinical guidelines for ultrasound screening for Hepatocellular Carcinoma (HCC) in western Europe. The risk of HCC is greater for people with cirrhosis and for people with hepatitis/HIV co-infection. Dr Sophie Willems and colleagues collected data from the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE). 646 people were included in the analysis. Their aim was to assess compliance with HCC screening guidelines in a large European cohort of HIV-positive people with hepatitis B or C co-infection and cirrhosis.
According to findings from the randomized phase 3 KEYNOTE-240 study, patients with previously treated advanced Hepatocellular Carcinoma (HCC) demonstrated reduced risk for death and improved progression free survival (PFS) with the addition of pembrolizumab. Richard S. Finn, MD, assistant professor of medicine in the department of medicine, division of hematology/internal medicine at David Geffen School of Medicine at UCLA and colleagues evaluated 413 patients. After a median follow-up of 13.8 months, 10.1% of patients continued to receive pembrolizumab and 3% remained on placebo. Compared with placebo, pembrolizumab improved OS and PFS.
According to American nutritionists, scientists have identified nuts as another potential cause of liver cancer. Nuts contain aflatoxins: the mycotoxin producing fungi – Aspergillus. Usually this fungus is found in soil, which may affect some food crops. Mycotoxins have long been recognized to be carcinogenic. On the other hand, nuts contain large amounts of vitamin E, which has a beneficial effect on the skin, cardiovascular system and brain. They also contain a lot of phytosterols, which regulate cholesterol levels.
New Liver Cancer Therapy To Be Added To The NHI
A second-line targeted therapy for end-stage liver cancer has been included in the National Health Insurance (NHI) as stated by the Director-General Lee Po-chang of the National Health Insurance Administration. Specialists suggest that medical practitioners and patients are exposed to undue stress by NHI rules. While the average life expectancy of a person with end-stage cancer is about six months, the use of the first and second-line therapies can extend that by 26 months on average, he said, adding that the administration’s policy is expected to significantly reduce the financial pressure on patients. First and second-line oral medication can inhibit the growth of blood vessels in tumors and tumor cells, delaying progression of the disease and boosting the survival rate for end-stage liver cancer, Lee King-teh, chairperson of the Taiwan Surgical Society of Gastroenterology said.
Sorafenib Plus Hepatic Arterial Infusion Chemo Improves OS In HCC With Portal Vein Invasion
According to a study, sorafenib plus hepatic arterial infusion chemotherapy (HAIC) in the first-line setting improved survival in patients with Hepatocellular Carcinoma (HCC) compared with sorafenib alone. Dr. MinKe He, MD, Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, in China, and colleagues assessed the safety and efficacy of using sorafenib plus HAIC versus sorafenib monotherapy in patients with HCC and portal vein invasion. Patients were enrolled from 5 hospitals across China between and followed-up with for 10 months. The results showed a median overall survival (OS) of 13.37 months in the combination arm versus 7.13 months in the sorafenib-alone arm.
Cstone Initiates Combination Therapy Trial For Advanced Liver Cancer
CStone Pharmaceuticals received approval to initiate clinical development in China of a combination therapy for patients with Hepatocellular Carcinoma (HCC). The multicenter, open-label and multidose phase 1b/2 study will evaluate the safety, tolerability and efficacy of CS1001, an anti-PD-LI monoclonal antibody, with BLU-554, a potent and highly selective inhibitor of fibroblast growth factor receptor 4 (FGFR4). CS1001 was well-tolerated and demonstrated anti-tumor activity in other cancers as well. BLU-554 was well-tolerated and demonstrated encouraging anti-tumor activity in a phase 1 study and was granted orphan drug designation for HCC by the FDA. “We expect the combination of BLU-554 with CS1001 can offer an important additional treatment option for this challenging disease,” said Frank Jiang, MD, PhD, chairman and CEO of CStone.
How Has US LI-RADS Performed In HCC Screening One Year After Implementation?
John D. Millet, MD, MHS, with Michigan Medicine in Ann Arbor and colleagues studied more than 2,000 patients to evaluate the performance of the ACR Liver Reporting and Data System (LI-RADS) for diagnosing Hepatocellular Carcinoma (HCC) on ultrasound. All patients had been assigned US LI-RADS observation categories and visualization scores. Cirrhosis was the most common indication for HCC screening at 51.4%, followed by non-cirrhotic hepatitis B virus (27.1%) and noncirrhotic hepatitis C virus (11.4%). the team concluded that the ACR’s scoring system implemented in 2017 emphasized sensitivity and negative predictive value.
Promising Early Results For BMS’ Investigational HCC Study
Bristol-Myers Squibb announced the first results from its investigational Opdivo (nivolumab) plus Yervoy (ipilimumab) cohorts of the Phase I/II CheckMate -040 study at the American Society of Clinical Oncology (ASCO) meeting 2019. The study evaluated the combination in patients with advanced Hepatocellular Carcinoma (HCC) previously treated with sorafenib. Patients experienced a median overall survival (OS) of 22.8 months with a 30-month OS rate of 44%. “We are encouraged by these early results which demonstrate a benefit/risk profile for the efficacy observed with the nivolumab plus ipilimumab combination in this cohort of CheckMate -040 that warrants further investigation,” said Faisal Mehmud, executive medical director, Bristol-Myers Squibb, UK and Ireland.
Blood Transfusion During Liver Cancer Surgery Linked With Higher Risk Of Cancer Recurrence And Death
According to new research being presented at this year's Euroanaesthesia congress held in Austria, receiving a blood transfusion during curative surgery Hepatocellular Carcinoma (HCC) is associated with a much higher risk of cancer recurrence and premature death. Findings showed that transfusion of 1 to 4 units of blood increased the risk of cancer recurrence by 23% and death by 55%. "The reason why blood transfusions substantially worsen cancer prognosis remains unclear, but it is likely to be related to the suppressive effects on the immune system" said Dr Ying-Hsuan Tai from Taipei Medical University Shuang Ho Hospital in Taiwan who led the research.
Different Types Of Medication That Could Cause Liver Cancer
Over the counter (OTC) pain relievers come with numerous side effects. They are interfering with the liver's primary role in the body. The drugs are said to cause toxic liver disease which in dire cases, causes death. Prescription drugs have been linked to various liver diseases. They stress the liver by subjecting it to overwork when purging toxins. Chemotherapy treatment can also cause more harm than the good to the liver.
According to a study conducted by scientists at Wake Forest School of Medicine, a targeted therapy using non-thermal radio waves has been shown to block the growth of liver cancer cells anywhere in the body without damaging healthy cells. The research team, led by Boris Pasche, M.D., Ph.D., chair of cancer biology and director of the Comprehensive Cancer Center, delivered levels of radio frequencies to mice that had been injected with human cancer cells to replicate Hepatocellular Carcinoma (HCC). This technology is already approved for use on humans in Europe, invented by Pasche and Alexandre Barbault, of TheraBionic GmbH in Ettlingen, Germany.
Radio-Wave Therapy Proves Effective Against Liver Cancer Cells
A recent study shows that a new targeted therapy using non-thermal radio waves can block the growth of liver cancer cells anywhere in the body without damaging healthy cells. The study was conducted by scientists at Wake Forest School of Medicine, part of Wake Forest Baptist Health. Using animal models, the research team headed by Boris Pasche, M.D., Ph.D., chair of cancer biology and director of the Comprehensive Cancer Center at Wake Forest Baptist, delivered levels of radio frequencies to mice that had been injected with human cancer cells to replicate Hepatocellular Carcinoma (HCC). The AM RF EMF activated a calcium channel on the surface of HCC tumor cells but not on noncancerous cells, explained Pasche who invented the device in collaboration with Alexandre Barbault, of TheraBionic GmbH in Ettlingen, Germany.
Discovery May Mead To Natural Ent-Kaurane Diterpenoid For NK-Based Tumor Immunotherapy
Natural killer (NK) cells play a significant role in the control of transformed cells at the tumor initiation stage through direct cytolysis, or cell disruption. NK cell-based immunotherapy is a potential therapeutic strategy. Research groups led by Prof. LI Yan and Prof. Puno Pematenzin from the Kunming Institute of Botany of the Chinese Academy of Sciences found that ent-kaurane diterpenoids, which show antitumor activity, are good candidates as sensitizer agents for NK cells. The results show that the natural ent-kaurane diterpenoid parvifoline AA (PAA) stimulates the expression of NKG2D ligands on Hepatocellular Carcinoma (HCC) cells, considerably enhancing their recognition and disintegration by NK cells.
Sorafenib Plus Chemo Combo Shows Benefit In Advanced HCC, But Phase III Trial Not Warranted
A recent study showed that the combination of sorafenib plus gemcitabine and oxaliplatin (GEMOX), was more beneficial compared with sorafenib monotherapy in patients with advanced Hepatocellular Carcinoma (HCC). Unfortunately, the study authors, led by Eric Assenat, MD, PhD, of the Université de Montpellier, Montpellier, France, determined a phase III trial was not warranted. 94 patients were randomized in their initial trial. The secondary objectives of this trial, conducted at 10 centers in France, included evaluating the safety of the experimental regimen.
Studying The Function Of Liver Cancer Genes In Mini-Organs
Researchers from the Hubrecht Institute and Radboud University have developed a human model in which they use organoids, or mini organs, to study the function of specific genes that are mutated in liver cancer. Organoids are mini organs that can be grown in the lab from a very small piece of tissue derived from a variety of organs. They found that mutations in BAP1, a gene commonly mutated in liver cancer, changes the behavior of the cells, which may make them more likely to be invasive. Studying the mutations in tumor formation is especially important in liver cancer.
The Medical City Offers Treatment Options For All Stages Of Liver Cancer
Microwave Ablation (MWA) is a technology that destroys tumors using heat generated by microwave energy. MWA uses electromagnetic waves. This is the most widely recognized in the treatment of hepatic and renal malignancies. It is like radio frequency ablation (RFA). MWA produces higher temperatures than RFA, which allows for a more complete thermal ablation in a shorter period. Image-guided tumor ablation is a treatment that can fight a wide range of tumors throughout the body. MWA was introduced by The Medical City in 2017.
Expert Breaks Down Latest Advances With Locoregional Therapies In HCC
With the help of technological advances in interventional radiology, patients with Hepatocellular Carcinoma (HCC) have been able to receive more accurate treatment delivery, which has led to stronger responses, said Emil Cohen, MD, an assistant professor at Medstar Georgetown University Hospital. The current standard care is transarterial chemoembolization. If the tumor is small enough, doctors recommend percutaneous ablation. For patients that are not eligible for transplant, radioembolization, external beam radiation, aggressive resection, or a combination of these are offered. In the past 5 years, microwave ablation has become more popular, since it is not as susceptible to some of the limitations that are often experienced with radiofrequency ablation.
Dr. Musher On Investigational Combination Therapies In HCC
The ongoing phase III IMbrave150 trial, which combines the VEGF inhibitor bevacizumab (Avastin) with the PD-L1 inhibitor atezolizumab (Tecentriq) is showing promise according to Benjamin Leon Musher, MD, associate professor of medicine, hematology and oncology, at Baylor College of Medicine. If the study does well there will be several frontline options to choose from. Strategies with immunotherapy, including CAR T-cell therapy, are also under investigation. The advantage with immunotherapy is that if patients achieve a response, the responses are durable, adds Musher. This, alongside biomarkers, will help guide treatment decisions one way or another.
Lilly's Cyramza Gets FDA Nod For Second-Line Liver Cancer
Eli Lilly and Company announced that the FDA has granted approval to its already approved cancer drug, Cyramza for the second-line treatment of patients with Hepatocellular Carcinoma (HCC). Their decision was based on the data from the REACH -2 study, which evaluated the benefit of Cyramza as a single agent in HCC patients who were intolerant to or experienced disease progression after treatment with Amgen/Bayer’s Nexavar. The data from the study showed that treatment with Cyramza in combination with erlotinib significantly delayed disease progression in previously untreated patients.
How Liver Protein Can Aid In Developing Vaccine For Hepatitis C
Researchers have identified small differences in a liver cell protein that can facilitate the development of a mouse model of chronic hepatitis C (HCV). Mice which were genetically engineered to produce human proteins called cyclophilin A, and with suppressed immune systems can be infected with HCV. “When we put this ‘humanized’ version of mouse cyclophilin A into liver cancer cells that normally do not replicate HCV, we saw increases in viral replication,” said Jenna Gaska, a graduate student at Princeton University. Different versions of cyclophilin A were tested in mouse liver cells which also contained several other proteins required for HCV entry and replication.
Riccardo Lencioni, MD states that Hepatocellular Carcinoma (HCC) is a unique cancer in that even those patients who are suitable candidates for radical therapy with resection or ablation are exposed to a very high rate of tumor recurrences. Unfortunately, outcomes are unsatisfactory in the long term. Lencioni believes that ongoing studies combining the best locoregional approaches with ablation, or chemoembolization, or radioembolization and the checkpoint inhibitors will try to clarify whether there is a synergy between these 2 therapies. These trials hope to offer more patients a chance for cure, or at least for a sustained response.
Abivax, a clinical-stage biotechnology company, has been collaborating with Scripps Research to develop novel treatments which harness the power of the immune system. The U.S. Food and Drug Administration (FDA) has accepted an investigational new drug (IND) application for ABX196, which showed potent efficacy in HCC animal models. The open IND allows Abivax to test ABX196 in combination with nivolumab (Opdivo), a checkpoint inhibitor, in a first Phase 1/2 clinical trial to treat patients with HCC. ABX196, both alone and in combination with a checkpoint inhibitor, showed a significant therapeutic effect in reducing tumor growth as measured by MRI and increasing survival in mice with HCC.
Enzo Biochem (ENZ) Issued U.S. Patent For Treatment Of Liver Cancer Using Ozanimod
Enzo Biochem, Inc. has announced that U.S. Patent approval entitled “Sphingosine Pathway Modulating Compounds for the Treatment of Cancers” that is directed to methods for treating Hepatocellular Carcinoma (HCC) using the compound Ozanimod. Elazar Rabbani, CEO of Enzo stated, “Our findings with Ozanimod provide further validation for targeting the sphingosine pathway in Hepatocellular Carcinoma and complement our current program to develop Enzo’s proprietary sphingosine kinase inhibitor, SK1-I, for the treatment of HCC. Animal xenotransplantation studies examining the efficacy of each of SK1-I and Ozanimod against tumors derived from human liver cancer cells are currently in progress.”
MR Imaging Evaluation Of Hepatocellular Carcinoma Treated With SBRT
According to a study, a standard response assessment such as modified Response Evaluation Criteria in Solid Tumors (mRECIST) should be used with caution after stereotactic body radiation therapy (SBRT) therapy, so that treatment response is not misinterpreted. The study also shows that arterial phase hyperenhancement (APHE) is a key feature of untreated or recurrent Hepatocellular Carcinoma (HCC). The study was conducted to determine the natural history of imaging findings seen by magnetic resonance imaging (MRI) of HCC treated with SBRT. Within the first 12 months after SBRT, size decreased in 66% of treated tumors.
Ramucirumab for Patients with AFP-High Hepatocellular Carcinoma Granted FDA Approval
The FDA have approved ramucirumab (Cyramza), developed by Eli Lilly, as a single agent in certain patients with Hepatocellular Carcinoma (HCC). The approval is based on data from the REACH-2 clinical trial evaluating the drug in 292 patients with advanced HCC with alpha fetoprotein (AFP) greater than or equal to 400 ng/mL who had disease progression on or after sorafenib or were intolerant. “Advanced liver cancer is an aggressive disease that has a poor prognosis – and for those with elevated AFP levels, the prognosis is even more dismal,” explained Levi Garraway, MD, PhD, senior vice president of global development and medical affairs at Lilly Oncology.
Highland Scientist’s Liver Cancer Therapy Passes Clinical Trials
Jun Wei, a professor of genetics at the Inverness-based University of the Highlands and Islands (UHI), has devised a kit to screen blood bank stock for samples which have high levels of a cancer-fighting antibody. Plasma containing the required high levels of the antibody can then be infused into patients to kill liver cancer cells. Clinical trials have showed that patients who received the new therapy survived for an average of one year longer than those who received conventional treatment. “This is a promising immunotherapy for cancer treatment with anticancer antibodies from our own blood,” said Wei. Qingdao Hailanshen Biotechnology has been supporting these clinical trials for over three years.
Hepatic Arterial Infusion Of Chemotherapy Improves OS In Hepatocellular Carcinoma Subset
According to a phase III trial, patients with Hepatocellular Carcinoma and portal vein invasion achieved longer overall survival (OS) with the addition of hepatic arterial cell infusion of FOLFOX to sorafenib. Previous trial shave shown that sorafenib alone has a median OS of 5.5 to 7.2 months. MinKe He, MD, of the department of hepatobiliary oncology at Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China and his team evaluated the safety and efficacy of hepatic arterial infusion of FOLFOX (oxaliplatin, fluorouracil and leucovorin) plus sorafenib vs. sorafenib monotherapy among 247 patients.
Liver Cancer Breakthrough At The Hormel Institute
Dr. Ningling Kang, head of the Tumor Microenvironment and Metastasis lab at The Hormel Institute, University of Minnesota and team analyze protein’s role in creating a tumor-promoting microenvironment. In their study they describe the importance of a protein that helps make the liver a good environment for tumor growth. Through recruitment of the cancer cells, hepatic stellate cells integrate into the tumor mass to become tumor-promoting myofibroblasts. The research group identified that a nuclear protein called p300 is required for the TGF-beta induced transition of hepatic stellate cells to tumor-promoting myofibroblasts.
Percutaneous Ablation Vs. Surgery For Hepatocellular Carcinoma
According to a recent study, percutaneous liver ablation interventions (IRs) in patients with Hepatocellular Carcinoma (HCC) are associated with lower in hospital mortality, length of hospital stays (LOS), and hospitalization costs as compared to surgery. A total of 557,071 hospitalizations in patients with HCC from 2002 to 2015 were extracted from the National Inpatient Sample database. This included 13,618 IRs and 44,629 surgical procedures performed. The results of the study results showed IR was associated with 78% lower in-hospital mortality, 37% higher routine discharge to home, 67% lower LOS, and 71% lower cost.
Can-Fite Moves Forward With Advanced Liver Cancer Therapy
The FDA granted both orphan drug designation and fast track status to Namodenoson, an advanced liver cancer therapy candidate from Can-Fite BioPharma. liver cancer therapy candidate from Can-Fite BioPharma, according to a press release. Can-Fite recently announced results from a phase 2 study of Namodensson, in which the therapy increased overall survival in patients with Hepatocellular Carcinoma (HCC). Namodenoson is a small orally bioavailable drug that binds to the A3 adenosine receptor. Despite not meeting the phase 2 primary endpoint, Can-Fite has a meeting with the FDA to review a plan for a phase 3 clinical trial.
Aflatoxins: A Cause Of Hepatocellular Carcinoma
The most common cause of Hepatocellular Carcinoma are aflatoxins. Aflatoxins are the byproducts of fungi that are found on agricultural crops like maize, peanut, cottonseed and tree nuts. There are more than 14 types of aflatoxins but AFB1, B2, G1, G2 are more common and carcinogenic to human and animals. When aflatoxin amounts increase, and when is a continuous exposure, this will cause AFBO to bind to the proteins and cause necrosis of the hepatocytes which can lead to cirrhosis. AFBO binds to DNA, which leads to genetic change in the target cell and causes DNA strand breakage. DNA base damage and oxidative damage ultimately leads to cancer.
Deals And Data In The Offing For Oncimmune
The London-listed diagnostics group Oncimmune, is focusing on growing sales, and is looking forward to publishing trial data soon. They are looking to use the immune system to diagnose cancer. Oncimmune sells EarlyCDT-Liver to detect Hepatocellular Carcinoma and has tests for many other cancers as well. Their current trial data involves the EarlyCDT-Lung cancer test. Oncimmune has an agreement with Genostics, in which Genostics has licensed the entire EarlyCDT portfolio.
Most Patients Stick With Milciclib In Tiziana Life Sciences Study
The biotechnology firm, Tiziana Life Sciences PLC, has reposted data from its clinical trial involving milciclib in patients with advanced liver cancer. 80% of patients who completed treatment within the phase 2a trial have requested continuation of the treatment. A safety review stated, the treatment "was not associated with unexpected signs or signals of toxicity" when administered to patients with advanced Hepatocellular Carcinoma. Ten patients were administered Milciclib over a six-month study period. "Demonstration of safety and clinical activity is important milestone to move forward with strategic options for further clinical development of milciclib either as a single agent or in combination with one of the [US Food & Drug Administration] approved drugs for treatment of [Hepatocellular Carcinoma] patients," said Tiziana Chief Executive & Chief Scientific Officer Kunwar Shailubhai.
Using Yttrium-90 For Liver Cancer Therapy In Clinical Stage
Radioembolization (Y90) is a minimally invasive procedure that combines embolization and radiation therapy to treat liver cancer. Tiny glass or resin beads filled with the radioactive isotope yttrium Y-90 are placed inside the blood vessels that feed a tumor. Pars Isotop Company is the main producer of the new radiopharmaceutical. Y-90 resin microspheres has been tested on 12 patients with liver cancer, with the help of Tehran and Shiraz Medical Sciences Universities. Radiopharmaceuticals can be used as diagnostic and therapeutic agents. Radiopharmaceuticals, or medicinal radiocompounds, are a group of pharmaceutical drugs which have radioactivity.
Urine-Based Liquid Biopsy For Non-Urological Cancers
Advances in technology and science, now use less invasive blood liquid biopsy for the study of cancer genetics. Early research was limited to tissue specimens obtained from invasive biopsy and surgical resections. Molecular biomarker research and show that tumor-derived DNA in the circulation can be detected in urine. Using Hepatocellular Carcinoma (HCC) as a study model, scientists further demonstrated the detection of ctDNA in the urine. The data results show that the HMW urine DNA was mostly derived from the sloughed-off cell debris of the urinary tract, and the LMW urine DNA was mostly derived from the circulation that was enriched for tumor-derived DNA alterations if a tumor was present.
What’s The Most Cost-Effective Imaging Method For Diagnosing, Monitoring HCC Patients?
According to a study published in the American Journal of Roentgenology. CT diagnosis and surveillance of Hepatocellular Carcinoma (HCC) is the most cost-effective imaging-based strategy. North American guidelines currently recommend ultrasound (US) surveillance every six months in patients at risk for HCC. According to Lima et al., strategies that rely solely on a single exam for surveillance and diagnosis, such as strategy E, are more likely to have higher rates of false-positive diagnoses. “Before implementing a surveillance program incorporating imaging modalities other than ultrasound, future studies should address the economic burden associated with false-positive HCC diagnoses. Also, future prospective trials should assess the accuracy of abbreviated MRI examinations in a surveillance setting,” the authors concluded.
Research Closer To Finding Ways To Help Patients With Hepatitis
MicroRNA are small, single-stranded non-coding RNAs that regulate T-cell immunity by targeting key factors, signaling and proteins and cytokines associated with T-cell activation, differentiation, and function. T-cell immunity plays a vital role in pathogen infections. Although the host innate immune system senses and responds to eliminate it, the hepatitis C virus evades the onslaught and establishes persistent infection in the liver. The immune system has developed two areas, innate and adaptive immunity. They work together to prevent infection and limit the damage done by invading bugs. While, liver resection remains the popular treatment for Hepatocellular Carcinoma (HCC), the aim of this study was to explore alterations of immune cells in HCC patients with liver resections. Regulatory T-cells are shown to increase the peripheral blood in HCC.
100 Patients From Odisha Undergo Liver Transplant At Gleneagles Global Hospital Hyderabad
Lakdi-ka-pul is currently host to one of the busiest and comprehensive liver disease management programs. The center performs adult as well as pediatric liver transplants. So far, they have performed over 700 liver transplants which includes over 100 pediatric liver transplants. The hospital has exclusive liver (Intensive Care Unit) ICU and liver (Occupational Therapy) OT. The visionary leader and well acclaimed surgeon and Chairman of Gleneagles Global Hospitals, Dr. K. Ravindranath dreamt to set up world-class multi organ transplant centers in India and collaborated with Kings College hospital in London. “If any of the liver tests are abnormal, then they definitely indicate the need for additional evaluation” he stated.
AGA Clinical Practice Update: DAAs For Hepatitis C And Hepatocellular Cancer
The American Gastroenterological Association collected evidence describing interactions between oral direct-acting antiviral (DAA) therapy for hepatitis C and hepatocellular cancer regarding incidence, recurrence, and efficacy. DAA treatments are associated with reduced incidence of hepatocellular cancer and relative reduction is similar for patients with and without cirrhosis. For patients with cirrhosis, achieving sustained virologic response, hepatocellular cancer incidence and hepatocellular cancer survival was similar between DAA-treated patients and interferon-treated patients. Conflicting studies fail to show conclusive data that DAA therapy is associated with differential time-to-recurrence, decreased or increased risk, or recurrent hepatocellular cancer aggressiveness in patients who achieve complete response to hepatocellular cancer therapy. DAA therapy should not be withheld from these patients, but DAA therapy can be deferred for 4 to 6 months to confirm therapy response Patients will also require indefinite surveillance every 3 to 6 months with dynamic contrast enhanced computerized tomography or magnetic resonance imaging.
Liquid Biopsy: An Old Concept With A New Twist
A liquid biopsy is a simple noninvasive alternative to tissue biopsies, in which a body fluid specimen is obtained for detailed laboratory analyses. A liquid biopsy for cancer detection or management is an old concept with a new twist. Tumor cells were first found in circulation in the late 19th century, and the term “cell-free DNA (cfDNA),” which referred to fragmented DNA found outside cells in the blood, was first reported by Mandel and Metais in 1948. Then, work in the 1970s revealed that patients with cancer tended to have an increased concentration of cfDNA in their blood. A study by Cohen and his team of scientists used a test called CancerSEEK that showed promise for cancer screening by liquid biopsies. Their cohort involved more than 1000 patients with cancer. Their findings suggested that individuals who test positive twice by liquid biopsy should undergo imaging to find the tumor site.
Patients with advanced Hepatocellular Carcinoma (HCC) demonstrated real-life benefit in a study with sorafenib (Nexavar) followed by regorafenib (Stivarga). Overall survival (OS) benefit with the sequence of targeted therapies was significant when calculated from the initiation of first-line treatment. Findings from the phase III RESORCE trial led to the approval in April 2017 of regorafenib as a second-line therapy for patients with unresectable HCC who had previously received treatment with sorafenib. Patients with HCC who received regorafenib after progression on sorafenib treatment demonstrated a median OS of 10.6 months.
Celsion Corporation Announces Issuance Of New Patent For Thermodox®
Celsion Corporation, a clinical stage oncology drug development company, announced that the United States Patent and Trademark Office has granted U.S. Patent No. 10,251,901 B2 – Thermosensitive Nanoparticle Formulations and Method of Making the Same. This new patent strengthens the coverage of ThermoDox®, Celsion’s heat-activated liposomal platform technology, currently in Phase III development for the treatment of primary liver cancer. The Company’s 556-patient global Phase III OPTIMA Study in HCC completed enrollment in August 2018 at 65 clinical sites in North America, Europe, China, S. Korea, Taiwan and Southeast Asia.
New Role For Innate Immune Sensor: Suppressing Liver Cancer
UT Southwestern researchers have found that a protein in the body's innate immune system that responds to gut microbes can suppress the most common type of liver cancer. They have shown that NLRP12, an innate immune sensor, has a protective effect against Hepatocellular Carcinoma (HCC). In this study, we demonstrated that NLRP12 responds to gut microbes and plays a critical role in suppressing a common form of liver cancer," said Dr. Hasan Zaki, Assistant Professor of Pathology at UT Southwestern and corresponding author of the study. To understand why this occurred, the researchers looked at the signals sent by tumor cells in mice with and without the NLRP12 gene. Dr. Zaki said his team is now further exploring the precise mechanism through which NLRP12 regulates the JNK pathway.
Some Patients May Be Eligible For Liver Resection After SIRT
Researchers have reported that patients that have undergone selective internal radiotherapy (SIRT) with yttrium-90 (Y-90) may be eligible for liver resection. To better understand the circumstances in which resection is possible, the investigators reviewed data on all patients who underwent liver resection following SIRT. There were 12 patients who were treated with SIRT followed by liver resection, 5 of which had HCC. According to RECIST (response evaluation criteria in solid tumors), there was a partial response shown in all cases. “In selected cases, liver resection is possible post SIRT. As this can represent a potentially curative option, it is important to reconsider resection in the follow-up of patients undergoing SIRT,” the researchers said.
Scientists from the Wellcome Sanger Institute in Cambridge are building a list of the most promising potential cancer drug targets. The team is using the DNA-editing tool CRISPR to switch off every gene, one-by-one, in over 300 different types of lab-grown cancer cells. So far, they’ve ranked 600 promising drug targets. Immune-boosting combo could help create cancer ‘vaccine factories.’ Scientists in the US are investigating the potential benefits of a highly purified version of the chilli compound capsaicin in slowing cancer spread. A trio of beagles were trained to ‘sniff out cancer.’ The dogs were able to pick out patients with lung cancer that had spread to other parts of the body with a 96.7% accuracy.
FDA Approves Expanded Monotherapy Label For Merck’s KEYTRUDA® (pembrolizumab)
In the Phase 3 KEYNOTE-042 trial KEYTRUDA monotherapy demonstrated a statistically significant improvement in OS compared with chemotherapy alone in patients. The study was a randomized, multi-center, open-label, active-controlled and enrolled 1,274 patients. KEYTRUDA is indicated for the treatment of patients with Hepatocellular Carcinoma (HCC) who have been previously treated with sorafenib. The recommended dose of KEYTRUDA is 200 mg as an intravenous infusion over 30 minutes every three weeks up to 24 months.
New Cancer Vaccine Study Has Similarities To U Of R Research
New York Mount Sinai Hospital tested the new vaccine on 11 patients who have advanced stage lymphoma and has shown to be successful. The vaccine is used in people who already have cancer. Immune stimulants are injected directly into a tumor to teach the immune system to destroy it. Some patients had full remission from months to years. The study was published earlier this month in Nature Medicine. "This is very different from a preventative vaccine," said Dr. Patrick Reagan, assistant professor of medicine at URMC. "This is a vaccine where we are actually trying to stimulate your immune system to attack the cancer." The vaccine is also being tested in the lab for liver cancer.
Ledipasvir/Sofosbuvir ± Ribavirin Effective, Safe In HCV With Advanced Liver Disease
A recent study involving multiple centers found that Ledipasvir and Sofosbuvir with or without Ribavirin is an effective and tolerable treatment in patients with hepatitis C virus (HCV)-infection with advanced liver disease. The study involved 200 patients with chronic hepatitis C with advanced liver disease to determine the association of ledipasvir and sofosbuvir treatment with a new occurrence and/or recurrence of HCC during and after antiviral treatment. HCC recurrence was less common in patients who received curative treatment for HCC compared with those who received noncurative treatment.
Can-Fite Announces Late-Breaking Abstract Presentation On Namodenoson™ Phase II Results At ASCO
Can-Fite BioPharma Ltd., a biotechnology company, just completed a multicenter Phase II trial in patients with advanced liver cancer. The trial was a randomized, double-blind, placebo-controlled trial evaluating efficacy and safety of namodenoson (CF102). Namodenoson is a small orally bioavailable drug that binds with high affinity and selectivity to the A3 adenosine receptor (A3AR). A3AR is highly expressed in diseased cells whereas low expression is found in normal cells. Namodenoson has been granted Orphan Drug Designation in the U.S. and Europe and Fast Track Designation as a second line treatment for HCC by the U.S. Food and Drug Administration. Namodenoson has also shown proof of concept to potentially treat other cancers as well.
Discovery Of A Host mRNA That Inhibits Immune Functions Of Antiviral Protein RIG-I
A group of scientists at Kanazawa University investigated the effects of SeP on antiviral immune responses in the liver, using cultured cells, mice and clinical specimens. They found that HCV infection augmented SeP expression in cultured cells. By analyzing clinical specimens, it was found that serum SeP levels were higher in HCV-infected patients. RIG-I protein was thought only to recognize RNAs of pathogens invading cells thus protecting against pathogens. So far, very few host mRNAs have been reported acting like SeP mRNA, which functions as a 'decoy' to bind RIG-I thus repressing its functions. This information is important for understanding immune tolerance in the liver and autoimmune diseases. The study is expected to lead to further investigations of host RNAs regulating RIG-I and to the development of clinical application targeting such mRNAs.
The Protein P38gamma Identified As A New Therapeutic Target In Liver Cancer
A recent research study conducted by a team of researchers at the Centro Nacional de Investigaciones Cardiovasculares (CNIC) led by Guadalupe Sabio has discovered an enzyme that could become a new pharmacological target in the treatment of liver cancer. They have shown an important role for p38gamma in the initiation of cell division in the liver, and that p38gamma and CDK2 both act as a tumor suppressor. To test whether p38gamma is implicated in cell division, study first author Antonia Tomás-Loba examined the outcome of chemically inducing liver cancer in mice that lack the enzyme. Her results were very promising.
Peripheral Neuropathy Reported In Liver Cancer Drug Stivarga
The Ministry of Food and Drug Safety plans to review the European Commission’s safety information about Stivarga (regorafenib). A patient reported peripheral neuropathy while taking Stivarga. Peripheral neuropathy causes infections in peripheral nerves at the tips of fingers and toes and makes them feel numb. In severe cases, patients find it difficult to walk, and experience a poor sense of balance. Result from the RESORCE trial on 573 patients in 21 countries showed the median overall survival of patients who used Stivarga after Nexavar treatment was 26 months. Stivarga was developed by Bayer as a potent in liver cancer treatment.
Personalized T Cells Destroy Common Liver Cancer
Researchers have engineered hepatitis B virus-specific T cells, a type of immune cell found in the body, to treat Hepatocellular Carcinoma. The t-cells were then individualized to the patient. The team successfully performed the approach on two liver transplanted patients who had hepatitis B virus (HBV) associated liver cancer recurrence. “In this study we showed that the integrated HBV-DNA gene components in the HCC cells were able to activate functional HBV-specific T cells,” says senior coauthor Antonio Bertoletti, a professor from the emerging infectious diseases program at Duke-NUS Medical School. The researchers plan to further refine the technique and treatment strategy with further research and trials to improve the efficacy of the therapy.
Blue Faery Grants Liver Cancer Research Award
This year Blue Faery: The Adrienne Wilson Liver Cancer Association announced their winner of the Blue Faery Award (BFA) for Excellence in Liver Cancer Research was given to Dr. Jinsil Seong, Professor at Yonsei University Medical College. Professor Seong is one of a few who pioneered radiotherapy of Hepatocellular Carcinoma. She has devoted her entire career on radiotherapy of HCC by practicing, educating and pursuing clinical research. Upon receiving the BFA Dr. Jinsil Seong stated, "I am truly honored and impressed to join world leaders in [the] HCC field who won the award previously. This encourages me to keep going forward for [a] better future of our HCC patients!" She is currently the president-elect of the Asia Pacific Primary Liver cancer Expert (APPLE) association, which is a world leading liver cancer association.
U.S. Liver Cancer Deaths More Common With Less Education
In a recent observational study, researchers collected data from the year 2000 through 2015. They found that nationwide, liver cancer death rates rose from 7.5 to 11.2 fatalities for every 100,000 men, and from 2.8 to 3.8 fatalities for every 100,000 women. These patients were between 25 and 74 years old. In men, however, the increases only occurred among those without a college degree. Among women, liver cancer death rates rose across all education levels, with the smallest increase for college-educated women. Risk of dying from liver cancer can mitigated if a person has a better job, better insurance, or a healthier lifestyle.
TGen Finds Gene Associated With Most Common Liver Cancer
Dr. Johanna DiStefano, head of the Diabetes and Fibrotic Disease Unit at Translational Genomics Research Institute (TGen) and researchers provide experimental evidence supporting the AKR1B10 enzyme as a promising therapeutic target for HCC. This gene was first identified and characterized in 1998. AKR1B10 has a conflicting role in HCC development and progression. An over-expression may indicate a patient has HCC, and the suppression of this gene may also be a way to stop cancer progression. AKR1B10 has emerged as a potential biomarker for the diagnosis and prognosis of HCC, studies show this enzyme also plays a role in the development and progression of HCC.
Hormone That Protects Women From Liver Cancer
Guadalupe Sabio at the Spanish National Center for Cardiovascular Research (CNIC) in Spain and staff have have discovered that a hormone that if present at higher levels in women, can keep them away from liver cancer. Their study also suggests that the disease is more common in men. Using mouse models, they found that inhibiting testosterone production in males, increased their adiponectin levels and reduced tumor growth. Most importantly, their study showed that adiponectin and metformin, a common antidiabetic drug, could be used as novel treatments for liver cancer.After A Delay, Can-Fite Digs Into Subpopulation Data As Liver Cancer Drug Fails To Hit Primary Endpoint
Israeli biotech Can-Fite missed the primary endpoint in a mid-stage test of its experimental late-stage liver cancer drug namodenoson. The study failed to achieve a boost in median overall survival across 78 patients with varying forms of advanced liver cancer. The A3 adenosine receptor agonist was originated by researchers at the National Institutes of Health. Last summer, Can-Fite delayed publication of the data from this trial, saying at the time that the delay was due to “the unexpected longevity of patients enrolled into this trial,” according to its medical director, Michael Silverman, M.D.
Whole Grains Help Reduce Liver Cancer By 40 Percent
Preliminary research advises that a diet containing whole grains may reduce the risk of liver cancer by 40 percent. Liver cancer, particularly Hepatocellular Carcinoma or HCC, is projected to become the third most common type of cancer by 2030. The study looked at over 125,000 patients and found that an increase of whole grains is related to a reduced risk of liver cancer. Those who consumed the highest amounts of whole grains had a 37 percent lower risk of liver cancer compared to those who consumed the least amount. The study showed that a diet high in whole grains helped to reduce many of the risk factors associated with HCC, such as inflammation.
Liver Resection Vs TACE For Intermediate Stage Hepatocellular Carcinoma
According to a study, liver resection may lead to better outcomes than transarterial chemoembolization (TACE) for cirrhotic patients Hepatocellular Carcinoma. The authors of the current study used a Markov model that compared liver resection with TACE over a 15-year period. Data from 31 studies were included in the analysis. Results revealed that patients in the resection group had a mean of 77.8 months expected survival time at 5 years and a survival rate of 47.1%. Those in the TACE group had 48.6 months mean survival and 25.7% survival rate. “Liver resection is superior to TACE regarding the OS of compensated cirrhotic patients with resectable intermediate‐stage HCC. Future large‐scale high‐quality studies are required to stratify patients at this stage for different optimal treatments,” the investigators concluded.
Diabetes Development Linked To Hepatocellular Carcinoma, Mortality In Hepatitis B
Researchers used study participant data from people with chronic hepatitis B (CHB) without diabetes mellitus (DM), from the Taiwanese National Health Insurance Research Database. It has been shown that for patients with CHB virus, development of DM is an independent risk factor for Hepatocellular Carcinoma (HCC). The study included information on over 2900 patients. At the 11-year follow up, 11.8% of participants developed HCC. Compared with participants without DM, participants with DM had significantly higher risk for HCC development.
Liver Cancer: Discovery Of New Biomarker For Liver Dysfunction Following Partial Hepatectomy
Liver failure is the most serious complication that can occur following liver resection. The tests available to gage pre-operative risk are expensive and time-consuming. A study done by MedUni Vienna research group has shown that a microRNA signature has the potential to serve as a rapid and reliable predictor. The team, led by Patrick Starlinger from MedUni Vienna's Department of Surgery and Alice Assinger from MedUni Vienna's Center for Physiology and Pharmacology, focused on the prediction of postoperative liver dysfunction and clinical outcomes that can be expected following liver resection. MicroRNA signatures are a new approach in this research and are already known as a significant diagnostic tool.
Research Suggests Liver Cells Are More Susceptible To Cancer
Researchers at the Abramson Cancer Center of the University of Pennsylvania have found that hepatocytes, the chief functional cells of the liver, make the liver more susceptible to cancer cells. The hepatocytes respond to inflammation by activating a protein called STAT3. This then increases the production of other proteins called SAA. These proteins remodel the liver and create the “soil” needed for cancer cells to “seed.” The researchers found that stopping this process by using antibodies that block IL 6, the inflammatory signal that drives this chain reaction, can limit the potential of cancer to spread to the liver. The team, along with researchers from the University of Kentucky showed in their study that therapies targeting hepatocytes may be able to prevent cancer from spreading to the liver.
Reprogramming T Cells To Attack Solid Tumors
An international team, led by Andrea Pavesi, at A*STAR's Institute of Molecular and Cell Biology (IMCB), have worked to genetically engineer human T cells to have them specifically attack liver cancer cells in patients with Hepatitis B, and to have the potential for long-term antitumor efficacy. Checkpoint inhibitor therapy uses antibodies to block inhibitory molecules that would otherwise stop T cells from attacking tumors. The receptor protein PD-1is the key to cell exhaustion and a target of checkpoint inhibitor therapy. Adoptive cell therapy involves modifying patient-derived T cells outside the body, to increase their potency, and then injecting them back into the patient.
Daily Aspirin May Reduce HBV-Related Hepatocellular Carcinoma Risk
A recent study conducted by Lee and colleagues in Taiwan, observed patients on a daily aspirin regimen. Their data showed that patients with hepatitis B virus and were giving aspirin daily, had a 29% lower risk of developing Hepatocellular Carcinoma. Between 1997 and 2012, the researchers recruited and screened 10,615 participants with chronic HBV. Of these patients, 2,123 received daily aspirin for 90 or more consecutive days. At 5 years, patients in the treated group had a significantly lower cumulative incidence of HCC than those in the untreated group. “Daily aspirin therapy may be of help to further improve the chemoprevention of HBV-related Hepatocellular Carcinoma,” Lee and colleagues concluded.
Novel Agents Offer Hope In Hepatocellular Carcinoma
Sorafenib (Nexavar) has been the only FDA-approved agent available for the first-line treatment of patients with HCC, up until a few years ago. Lenvatinib (Lenvima) has shown to be non-inferior to sorafenib as presented in the findings of the phase III REFLECT trial. Additionally, the FDA review of ramucirumab (Cyramza) is very much anticipated as well. According to Michael A. Morse, MD, FACP, MHS, Cyramza differs from the other drugs on the market in that it is a recombinant monoclonal antibody that binds to VEGFR2, and for which there may be a biomarker. Researchers from the phase III REACH-2 trial have shown improved overall survival (OS) as compared with patients taking the placebo and who had previously been treated with sorafenib.
Results Of Early-Stage Liver Cancer Detection Using Liquid Biopsy Published
A recent pilot study done by researchers from the National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Sciences and Genetron Health (Beijing) Co. Ltd (Genetron) focused on early detection of liver cancer in a cohort of HBV carriers at risk for developing HCC. The screening technology, known as HCCscreen, relies on detecting a combination of tumor-specific mutations in cell free DNA (cfDNA) and protein markers. A total of 331 HBV carriers were tested using HCCscreen. The combination of these markers enabled excellent performance of the assessment in a cohort of HBV carriers who had no other symptoms. Using a noninvasive blood test, the liquid biopsy technology can provide important diagnostic indicators HBV carriers. The research team is currently conducting a larger scale clinical trial to further improve and validate the method.
Preclinical Data Shows Combination Immunotherapy Could Stop Liver Cancer Growth
Researchers from UC San Diego Moores Cancer Center recently reported that combining two reagents effectively stopped the progression of Hepatocellular Carcinoma (HCC). They successfully combined a synthetic double-stranded RNA (dsRNA) polyinosinicpolycytidylic acid (polyIC) with a programmed death-ligand 1 (PD-L1) antibody to achieve this. Feng’s team discovered unexpectedly that polyIC strongly boosts several anti-tumor immune functions in the liver, and that it prevents HCC if administered in the pre-cancer stage. Otherwise, once the tumor is already formed, polyIC has no effect. More research will be done to develop a liver cancer prevention strategy for the large population of patients with chronic liver disease and who at risk for liver cancer development.
Lucence Diagnostics To Develop AI Tools For Liver Cancer Treatment
Lucence Diagnostics has recently announced their new project to develop AI algorithms for improving diagnosis and treatment of liver cancer. Lucence Diagnostics is a genomic medicine company with hopes for a world without avoidable cancer deaths. They specialize in non-invasive blood tests that improve cancer detection and treatment selection. Researchers, led by Olivier Gevaert, PhD, Assistant Professor of Medicine and of Biomedical Data Science at the Stanford University School of Medicine, will use tumor imaging and molecular data of liver cancer patients to help doctors make better treatment decisions. This study will evaluate over 5,000 patients.
Computer Neural Network Shows Potential For Liver Cancer Diagnosis
Researchers from Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, the Second Hospital of Suzhou University and other research institutions have developed the neural network for HCC grading. They achieved this by combining two classic neural networks and training the network with enhanced nuclear magnetic resonance images using 75 patients. The grading of HCC is very important in the clinical diagnoses, treatments and prognoses of the disease. Their proposed model achieved an accuracy of 83% in classifying HCC. Researchers plan to use the model for liver cancer diagnosis and treatment system, which will help doctors make better surgery plans for liver cancer patients.
Eating Tomatoes To Fight Liver Cancer
A recent study using mouse models found that the lycopene in tomatoes reduced fatty liver disease, inflammation, and liver cancer development caused by high-fat diets. Xiang-Dong Wang, a senior scientist and associate director of the Jean Mayer USDA Human Research Center on Aging at Tufts, is conducting several studies to see how food can help prevent cancer development. One of the foods of interest is tomatoes, which are rich in lycopene, a naturally occurring pigment that gives many fruits and vegetables their reddish hue. Researchers evaluated how well tomato powder protected mice against inflammation and cancer, that were originally infected with a liver carcinogen and then fed an unhealthy high-fat diet.
Innovent Biologics, Inc. has announced that the first patient has been dosed in ORIENT-32 trial. This trial that evaluates Tyvyt® (sintilimab injection) as first-line treatment for patients with advanced Hepatocellular Carcinoma. 566 patients will be enrolled in the study. Tyvyt® is an innovative drug jointly developed in China by Innovent and Eli Lilly and Company. Currently, more than twenty clinical studies of sintilimab injection, including seven registration studies, are ongoing to evaluate the efficacy of sintilimab injection on other solid tumors.
HIV Infection Linked To Shorter Survival In Hepatocellular Carcinoma
HIV seropositivity appeared associated with shorter overall survival among patients with Hepatocellular Carcinoma despite sufficient antiretroviral treatment, according to results of a global multicohort study published in Journal of Clinical Oncology. Researchers analyzed 1,588 patients with HCC who received no prior anticancer treatment which included 132 HIV-positive patients and 1,456 HIV-negative patients. Results reported overall survival of 2.2 months among HIV-positive patients and 4.1 months among those not infected with HIV. The inferior probability of survival that accompanies HCC patients with HIV deserves to be considered in patient counseling and therapeutic decision-making. Mechanistic studies on clinical samples evaluating the immunopathologic features of HIV-associated HCC in comparison with HIV-negative controls are urgently required.
Pembrolizumab Misses Primary Endpoints in HCC Trial
The KEYNOTE-240 trial (NCT02702401) has reportedly failed at its coprimary endpoints, progression-free survival (PFS) or overall survival (OS). KEYNOTE-240 is the confirmatory trial for pembrolizumab, which was granted an accelerated approval in November 2018 for patients with HCC who were previously treated with sorafenib (Nexavar), based on data from the phase II KEYNOTE-224 trial. In the double-blind, phase III KEYNOTE-240 trial, 413 patients were randomized to receive pembrolizumab plus best supportive care versus placebo plus best supportive care in patients with advanced HCC who previously received systemic therapy. The safety profile of pembrolizumab in KEYNOTE-240 was consistent with what has been observed in prior studies with the PD-1 inhibitor.
Hepatocellular Carcinoma Diagnosis, Prognosis And Treatment May Improve By Identifying A Protein
Researchers at Ulsan National Institute of Science and Technology have found elevated expression of tonicity-responsive enhancer-binding protein (TonEBP) in the tumor tissue of more than 90% of patients studied and was more prevalent than any other molecular marker used to detect Hepatocellular Carcinoma in tumor tissue. They also found that higher tumor TonEBP expression was associated with larger tumor size, advanced tumor grade, recurrence and its migration to other parts of the body, thus acting as a useful tool in predicting Hepatocellular Carcinoma prognosis. Tone’s role in Hepatocellular Carcinoma is linked to its involvement in inflammation. Targeting TonEBP could be an attractive strategy to prevent the development, spread and recurrence of hepatocellular carcinoma.
Teasing Out The Three Subtypes Of Liver Cancer
A research team based at Tokyo Medical and Dental University (TMDU), Japan, has combined genomic and immunological data to classify Hepatocellular Carcinoma into three distinct subgroups. The team, led by Professor Shinji Tanaka, combined data on mutations, gene expression patterns and immunological status to shed light on the variation among cases. They reviewed the data of 183 surgically removed HCC tumors. The researchers revealed three types of HCC, tumors with mutation in the CTNNB1 gene and immune suppression, tumors associated with conditions such as obesity and diabetes, and tumors with genomic instability. Patients with tumors belonging to the third group had a worse prognosis.
Eureka Plans US Trial Testing ET140202 T-cell Therapy in Liver Cancer Patients
Eureka Therapeutics is planning a Phase 1/2 clinical trial in the United States scheduled to begin sometime in the first half of 2019. The trial will focus on safety and effectiveness of its investigational T-cell therapy ET140202 in patients with advanced Hepatocellular Carcinoma. ET140202 is a new T-cell therapy product that uses natural mechanisms of T-cells to fight cancer. In an ongoing Phase 1 trial (NCT03349255) in China, ET140202 was safe and did not cause the normal side effects associated with other T-cell treatments. In the trial, three of the six patients experienced a reduction in tumor size, and one had a complete response.
Study Reaffirms Safety of Hepatitis C Meds in Liver Cancer Patients
Recent research findings contradict previous research suggesting that antiviral drugs might increase these patients' risk of liver cancer recurrence. The previous study which involved a single-center study from Spanish investigators in 2016 that "gained a lot of press and sparked fear about treating liver cancer patients for their hepatitis C," said Dr. Amit Singal, medical director of the liver tumor program at UT Southwestern Medical Center, in Dallas. The investigators compared liver cancer recurrence in those who were and were not given direct-acting antivirals for hepatitis C. The cancer recurrence rates were 42 percent among those who received the antiviral drugs and 59 percent among those who did not receive the medication.
Dual Modality Radiation May Improve Survival in HCC with Gross Vascular Invasion
Researchers show that patients with Hepatocellular Carcinoma (HCC) and gross vascular invasion (GVI) may have improved overall survival (OS) after being treated with dual modality radiation with external beam radiation therapy (EBRT) and transarterial radioembolization (TARE). Systemic therapy such as sorafenib has had poor outcomes for patients with HCC and GVI, so researchers undertook the study to determine whether there were differences in outcomes using dual modality radiation (EBRT+TARE) compared with EBRT alone. For the 12 patients who had EBRT and TARE delivered within 2 months as planned, median progression-free survival (PFS) was 218 days for dual modality radiation compared with 63 days for only EBRT.
Liver Cancer Becoming Prominent Among Indian Youngsters Due to Poor Lifestyle
While surgery to remove a liver tumor offers the best chance for a cure, surgery is not an option for more than two-thirds of patients with primary liver cancer. Approximately, seventy percent of patients with liver cancer cannot opt for surgery for many reasons. Interventional radiologists may perform minimally invasive surgeries like embolization or thermal ablation, etc., depending on the patient’s case history. These minimally invasive therapies use imaging techniques such as CT, ultrasound, or MRI to guide the delivery of treatments directly to tumor sites. There are several types of thermal ablation, including radio-frequency ablation, which uses radio waves to super-heat the tumor, and cryoablation, which freezes the tumor.
Biomarkers Associated with Response to Regorafenib in Patients with Hepatocellular Carcinoma
Researchers analyzed plasma and tumor samples from study participants to identify genetic, microRNA (miRNA) and protein biomarkers associated with regorafenib. Archived tumor tissues and baseline plasma samples were obtained from patients with Hepatocellular Carcinoma (HCC) given regorafenib in the RESORCE trial. They analyzed baseline plasma samples from 499 patients. In the RESORCE trial, expression patterns of plasma proteins and miRNAs that related to increased overall survival times of patients with HCC following treatment with regorafenib were identified.
Hepatitis C virus (HCV) is an infection which causes complications such as cirrhosis, liver disease, Hepatocellular Carcinoma, and many people die as a result. The first prospective, longitudinal study investigating treatment of chronic hepatitis C with direct-acting antivirals, comparing treated and untreated patients, finds that the treatment is associated with reduced risk of mortality and liver cancer, according to a study published in The Lancet. Patients who were treated were 52% less likely to die prematurely than people who were not treated and 33% less likely to present with Hepatocellular Carcinoma. The study suggests this treatment should be considered for all patients with chronic hepatitis C infection.
Study: Anti-Cancer Gene May Fuel Tumor Growth
According to a study by researchers at the University of California, San Diego, a cancer-fighting gene known as the “guardian of the genome” promotes certain tumors. The study demonstrates a point that oncologists have been making for decades: Cancer is not one disease. Researchers led by Yang Xu based their results on studies of human patients, cell samples and mouse models of cancer. Xu and colleagues found that restoring p53 function in mutated liver cancer cells improves their metabolism by indirectly causing cells to switch to a process called glycolysis. This metabolic change to glycolysis, called the Warburg effect, has been recognized for decades as a characteristic of cancer. In liver cancers, promoting p53 function will induce this metabolic shift, energizing the cancer.
A Hidden Route for Fatty Acids Can Make Cancers Resistant to Therapy
Researchers from the lab of prof. Sarah-Maria Fendt at the VIB-KU Leuven Center for Cancer Biology have demonstrated that certain tumor cells use an alternative pathway to produce fatty acids. Fatty acid metabolism is an essential process in tumor growth and proliferation. Study outcomes have not always been positive when attempting to block fatty acid metabolism as a therapeutic strategy. It has been found that stearoyl-CoA desaturase (SCD) is the enzyme that is the only source of newly produced mono-unsaturated fatty acids, which are required for membrane generation. The presence of this alternative metabolic pathway was identified in isolated cancer cells and in lung and liver tumors samples from mice and human patients.
Hepatocellular Carcinoma: H-Prune Gene Regulatory Networks
Haotian Liao and colleagues, at the Liver Surgery and Liver Transplant Dision at the West China Hospital, thoroughly analyzed the role of the H-Prune protein in HCC. The H-Prune protein has associated with lung cancer, breast cancer, medulloblastoma and colorectal liver metastases. The team has shown that H- Prune functions as a tumor promoter in HCC. These findings highlight the importance of a wider approach as a powerful tool to infer the dynamics of cancer. Liao and his team will continue to do more research.https://www.ebiomedicine.com/article/S2352-3964(19)30079-9/fulltext
Alcoholic Drinks Are Volatile Cocktail In Liver Cancer Link
Primary liver cancer is serious and often linked to excessive alcohol consumption. Unfortunately, more people are dying from the disease. Alcohol is a direct contributor to liver cancer, as excessive alcohol consumption is a chief cause of cirrhosis of the liver which happens when scar tissue builds up on the liver stopping it from working properly.
Dr. Li On Preoperative Immunotherapy In Hepatocellular Carcinoma
A lot of focus in HCC has been placed on the use of immunotherapy in the frontline metastatic setting, says Li. One study (NCT03222076) of interest evaluated the use of either nivolumab (Opdivo) monotherapy or the combination of nivolumab and ipilimumab (Yervoy) in patients with resectable disease in the preoperative or adjuvant setting.
Crunching The Data: New Liver Cancer Subtypes Revealed Immunologically
A research team based at Tokyo Medical and Dental University (TMDU) has used an integrated data analysis to classify Hepatocellular Carcinoma, the most common type of liver cancer, into three distinct subgroups, which should aid targeted treatment.
Anti-Rejection Drug Rapamycin Shows Promise In Liver Cancer
Scientists at the University of Pittsburgh School of Medicine were studying the cells that surround the liver’s central vein when they made a serendipitous discovery. Cells with a mutation in a gene called β-catenin also made high levels of the mTOR protein—a fault that they believe could promote the development of cancer.
Commonly Used Anti-Rejection Drug Could Be Repurposed To Treat Some Liver Cancers
Satdarshan Monga, M.D., professor of pathology and the founding director of the Pittsburgh Liver Research Center at Pitt's School of Medicine and his team of researchers discovered a new use for a commonly used anti-rejection medication. Approximately 20% – 35% percent of liver cancers have a β-catenin mutation, but there is little understanding of how and why these mutations aid the growth of cancer cells. When Monga found similarly high levels of active mTOR in β-catenin mutated liver cancers, he wondered whether the two proteins could be functionally linked.
FDA Accepts New Drug Application For Liver Cancer T-Cell Therapy
FDA has cleared its investigational new drug application for ET140202 ARTEMIS T-cell therapy for patients with Hepatocellular Carcinoma. Patients who are positive for alpha-fetoprotein could benefit from this new medication. Results from a first-in-human study in China showed that ET140202 demonstrated a favorable safety profile in six patients with no observed neurotoxicity. Additionally, three of the six patients achieved tumor regression. Cheng Liu, PhD, president and CEO of Eureka Therapeutics said, “This is an exciting time for Eureka as we prepare to initiate our U.S. clinical trial in patients with Hepatocellular Carcinoma.” Eureka plans to initiate a phase 1/2 multicenter clinical trial in the U.S. during the first half of 2019.
Fibrosis Markers Tied To Mortality After Liver Cancer Surgery
A retrospective study suggests that markers of fibrosis, the thickening and scarring of connective tissue, is linked to mortality and survival after liver resection. Dr. Maegawa of Southern Arizona Veterans Affairs Health Care System, Tucson, AZ, and colleagues analyzed 475 patients who underwent hepatectomy between 2000 and 2012. Dr. Maegawa explained that while resection is usually the preferred therapy, tumor ablation and transplant are great alternatives. "This information should be integrated into an overall clinical assessment …. when determining who may be suitable and what the risk is of liver resection for Hepatocellular Carcinoma." stated Dr. Maegawa.
Stereotactic Body Radiation Shows Sustained Local Control In Hepatocellular Carcinoma
According to a North American pooled analysis, presented at Gastrointestinal Cancers Symposium, stereotactic body radiation therapy showed promising rates of local control and survival in patients diagnosed with early-stage HCC. “Stereotactic body radiation therapy is a noninvasive, ablative treatment for patients with Hepatocellular Carcinoma,” Ashwathy Susan Mathew, DNB, MBBS, MD, clinical fellow in the department of radiation oncology at Princess Margaret Cancer Centre, and colleagues wrote. Analysis included 310 patients with stage I to stage IIIa HCC treated with radical-intent SBRT. Overall, 37.9% of patients achieved 3-year overall survival and 23.5% achieved 5-year overall survival.
A recent study shows that treatment with sorafenib (Nexavar) followed by ramucirumab (Cyramza) extends overall survival. Andrew Zhu, MD, of Massachusetts General Hospital Cancer Center and Harvard Medical School in Boston, and colleagues observed 292 patients with Hepatocellular Carcinoma and high levels of alpha-fetoprotein. At the 7.6-month follow-up, median OS was 29% longer in patients who received ramucirumab. The median duration of therapy was 12 weeks. Potential limitations of REACH-2 include the exclusion of patients with severe liver cirrhosis because of their high risk of mortality independent of cancer, said Ghassan Abou-Alfa, MD, of Memorial Sloan Kettering Cancer Center in New York City.
Doctors Suggested Which Beverage May Protect Against Liver Cancer
As millions of people world-wide drink coffee and wonder whether it is useful or destructive to your health, researchers have compiled a list of benefits. Coffee has been shown to reduce several health risks. Studies show that people who drink coffee are 80% less likely to develop cirrhosis of the liver and reduces the risk of liver cancer. Coffee contains special antioxidants which prevents oxidative stress to the cells, and this slows the aging process. Coffee has also been shown to reduce the risk of type II diabetes, Parkinson’s disease, and Alzheimer’s disease.
The HealthWell Foundation, an independent non-profit that provides financial assistance for inadequately insured Americans, has opened a new fund to help Medicare patients who are living with HCC. HealthWell will provide up to $8,000 in copayment or premium assistance to eligible patients. Suzanna Masartis, Executive Director for Community Liver Alliance, commented "Medicare patients living with HCC are particularly hard hit by the financial burden of disease treatment and, often, forgo treatment all together. The CLA applauds the HealthWell Foundation for the launch of the new HCC fund, which clearly addresses an unmet need for these patients."
Immunicum AB has published the final data analysis from the exploratory clinical study of ilixadencel in patients with advanced Hepatocellular Carcinoma (HCC) in the journal, Frontiers in Oncology. In September 2017, the Phase I/II clinical study of 17 patients with unresectable and/or metastatic HCC investigated the safety and tolerability of ilixadencel. Ilixadencel was administered either as a second-line therapy for patients not responding to previous treatment with sorafenib or as a first-line therapy alone or in combination with sorafenib. The results of the study confirmed the safety of ilixadencel as a single treatment, or in combination with sorafenib.
BTG is a global specialist healthcare company, and the creator of the DC Bead LUM treatment. DC Bead LUM is the first commercially available bead which can be loaded with doxorubicin or irinotecan for the local treatment of tumors in patients with Hepatocellular Carcinoma (HCC). Dr Anthony Wilkinson, BTG Regional Medical Director commented, "Feedback from both physicians and their patients indicate that DC Bead LUMI™ is an important advance in personalized, loco-regional cancer therapy. As a leader in intra-hepatic therapy for HCC, BTG is excited to be able to launch our latest Drug-Eluting Bead product in the Australian market. We anticipate that the enhanced visualization of DC Bead LUMI™ will lead to improved patient outcomes through more accurate delivery."
Based on a study conducted by researchers at UT Southwestern Medical Center (UTSWMED), disproves the idea that Hepatitis C antiviral medications may lead to a higher recurrence of liver cancer. It was shown that 42 percent of liver cancer survivors who were treated with direct-acting antivirals (DAAs) experienced a recurrence of their liver cancer, compared with 59 percent of patients who were not treated with antivirals. Dr. Amit Singal, Associate Professor of Internal Medicine and Medical Director of the Liver Tumor Program, said, “Based on these new data, providers can feel reassured that it is safe to treat hepatitis C in these patients and allow them to receive the known benefits of hepatitis C therapy.”
Are Response Rates Predictive Of Survival Outcome In HCC?
The phase III REFLECT trial assessed tumor response using modified RECIST criteria (mRECIST) to predict overall survival in HCC patients. These patients were treated with lenvatinib or sorafenib. Results showed median overall survival in the full study was 13.0 months, with 13.6 months with lenvatinib, 12.3 months with sorafenib. The median overall survival among responders in the full trial was 22.4 months, compared with only 11.4 months in nonresponders.
Celsion Announces Publication Of Thermodox Study Results In Radiology
Results from the Phase 1 TARADOX trial have published in the journal Radiology. The study evaluated the safety and efficacy of ThermoDox, a heat-activated liposomal encapsulation of doxorubicin, along with focused ultrasound for the treatment of liver cancer. ThermoDox was developed by Celsion Corporation, an oncology drug development company. Researchers evaluated patients with inoperable primary or secondary liver tumors who had previously received chemotherapy. Safety was assessed by analyzing patients' MRIs.
Abou-Alfa Highlights HCC Advances, Unmet Needs In Other GI Cancers
Ghassan K. Abou-Alfa, MD. In August 2018 the FDA approved the use of lenvatinib (Lenvima) as a frontline treatment for patients with unresectable HCC. This was due to the positive results from the phase III REFLECT trial which compared it to sorafenib (Nexavar). Nivolumab (Opdivo) has been approved as a second-line treatment, while its potential as a frontline agent is anticipated in the CheckMate-459 trial. Most recently, the FDA approved cabozantinib (Cabometyx) as a treatment for patients with HCC who previously received sorafenib, based on the findings from the phase III CELESTIAL trial. Additionally, ramucirumab (Cyramza) has also been assessed as a potential second-line treatment for those who progress on sorafenib in the phase III REACH-2 trial.
News Of Note — A Startup’s Phase 2 Drug Slows Liver Cancer In Mice
eFFECTOR has raised more than $110 million since it was founded in 2013 to study a small molecule designed to block two cancer-promoting enzymes. Their Phase 2 drug, eFT508, has been shown to stop liver cancer in mice. Davide Ruggero, Ph.D., a UCSF researcher and co-founder of eFFECTOR, discovered that in mice with liver tumors driven by the genes MYC and KRAS, the drug slashes levels of the immune-suppressing protein PD-L1 in half. The survival rate of the mice improved following the treatment with eFT508.
African-Americans May Live Longer After Liver Transplant If Their Donors Are The Same Race
A new study found that African-American adults undergoing liver transplant to treat liver cancer lived significantly longer when the organ donor was also African-American. It has been shown that African-American patients with (HCC), have the poorest long-term survival and have worse outcomes after a liver transplant. This study determined that at five years after transplant, 64.2 percent of race-matched patients were still alive compared with 56.9 percent of unmatched patients, and a median overall survival of 135 months versus 78 months.
In interactive HCC symposium, to be chaired by Alan P. Venook, M.D., FASCO, Madden family distinguished professor of medical oncology and translational research at the University of California, San Francisco (UCSF) will take place at the ASCO 2019 annual conference. The symposium will also include other scientists discussing clinical issues related to the management of patients with HCC. Physicians’ Education Resource has been dedicated to advancing cancer care since 1995.
Doctors are hoping to prevent the dangerous side effects of toxic chemotherapy with the help of sponges that are inserted in the bloodstream to absorb excess drugs. The "drug sponge" is an absorbent polymer coating a cylinder that is 3D printed to fit precisely in a vein that carries the blood flowing out of the target organ. it would soak up any drug that was not absorbed by the tumor, preventing it from reaching and potentially poisoning other organs. Steven Hetts, an interventional radiologist at UC San Francisco and his team of scientists are currently testing the “drug sponge” on a pig liver to determine how much drug is absorbed. Hetts says that the technique is superior to another liver cancer treatment now undergoing testing, which requires major endovascular surgery and involves dialysis.
Phase 3 Trial Explores Cabometyx-Tecentriq Combo Therapy In Advanced Liver Cancer
Cosmic-312 is a phase 3 clinical trial testing a combination of Cabometyx (cabozantinib) with Tecentriq (atezolizumab) versus Nexavar (sorafenib) in previously untreated patients with advanced Hepatocellular Carcinoma (HCC). The study will include about 640 patients in almost 200 locations internationally. Tecentriq is a type of therapy called immune checkpoint inhibitor, which works by binding to the PD-L1 protein to block cancer cells from invading the immune system. The aim of this clinical trial is to extend life.
Saffron May Contain Cancer-Beating Properties, UAE Research Finds
A new research at the UAE University has revealed that a saffron extract called safranal, could have important cancer-beating properties. Ms. Al Mansoori, a master's degree student at UAEU assisted with the research. She began by injecting carcinogens into live rats. Biochemical tests indicated that safranal stopped the cell cycle in the cancer cells from dividing and multiplying. A team of researchers at New York University Abu Dhabi indicated that safranal could kill human liver cancer cells as well.
Considerations For Using Nivolumab In Advanced HCC
A discussion surrounding clinical study CheckMate 459, which compares sorafenib to nivolumab. Ghassan K. Abou-Alfa, MD states, “We are very heavily involved with checkpoint inhibitors in HCC [Hepatocellular Carcinoma].” Peter Galle, MD, PhD explains that checkpoint inhibitors are basically a break which, in the end, stops the immune system from overreaction. Riad Salem, MD states brings up the topic of real progression versus pseudoprogression.
Dose Escalation In Liver Cancer Study With ADP-A2AFP (AFP) SPEAR T-Cells
Adaptimmune Therapeutics is recommending a dose escalation in the ongoing ADP-A2AFP (AFP) study in patients with Hepatocellular Carcinoma (HCC). During the first cohort, two patients received 100 million transduced SPEAR T-cells and showed no sign of toxicity. Adaptimmune Therapeutics is a leader in T-cell therapy to treat cancer. This is a first-in-human, open-label study including up to 36 patients with escalating target doses of transduced SPEAR T-cells. In the first cohort the dose was 100 million. In the second cohort researchers will use 1 billion, and in the third cohort 1.2-6 billion while evaluating safety.