Liver Cancer News

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Phase 3 ORIENT-32 Trial Shows Promise For First-Line Treatment Combo In HCC
28 September 2020
The phase 3 ORIENT-32 trial is testing the combination of sintilimab injection (Tyvyt) in combination with bevacizumab biosimilar injection (Byvasda or IBI305) as a first-line treatment for patients with advanced Hepatocellular Carcinoma (HCC) to measure progression-free survival (PFS) and overall survival (OS). The researchers will compare the results to treatment with sorafenib. This study is being conducted in China. Based on the interim analysis conducted by the Independent Data Monitoring Committee (IDMC), the combination has demonstrated a statistically significant improvement in PFS and OS compared with sorafenib. “In China, HCC is the fourth most common malignancy with the second-highest mortality rate. More than half of new and fatal cases of HCC in the world occur in China every year,” explained the principle investigator of the study, Fan Jia, Ph.D., from the Zhongshan Hospital of Fudan University.

Stivarga More Potent In Improving Asian Patients’ Survival
25 September 2020
Professor Lim Ho-Yeong of the Department of Hematology and Oncology at the Samsung Medical Center presented results of the REFINE study, a prospective real-world trial on Stivarga which showed that Bayer’s Stivarga ( regorafenib) had a 54 percent improvement in survival extension in real-world data of Asian patients, compared to the survival improvement shown in the previous clinical trial. The REFINE trial is an observational study that prospectively analyzed the effects of Stivarga as a secondary or higher treatment in 500 patients with unresectable HCC. The study results showed that the median overall survival (OS) of 182 patients was 16.3 months, a 52 percent increase compared to 10.6 months shown in the phase-3 RESORCE study, Lim said. The median OS was also longer than 13.2 months.

Singapore Scientists Discover Human Liver Cancer Cells Masquerading As Fetal-Like Cells
24 September 2020
A team of researchers from A*STAR’s Genome Institute of Singapore (GIS), Singapore Immunology Network (SIgN), National Cancer Centre Singapore (NCCS), and KK Women’s and Children’s Hospital (KKH), collaborated to identify “fetal-like” reprogramming of the tumor ecosystem in human Hepatocellular Carcinoma (HCC). Previous studies have shown the similarities between embryonic development and tumors, specifically in the expression of fetal-like antigens in cancers. Alpha-fetoprotein (AFP) is one of the key oncofetal proteins found to be elevated in more than 80% of HCC. The researchers discovered that during the development of the fetal liver, which is a process that shares many characteristics typically associated with cancer growth, these fetal endothelial and macrophages help in organ growth and protect the tissue against the body’s immune system.

Post-HCV Treatment Liver Stiffness Linked With Adverse Outcomes
22 September 2020
According to a recent study, higher fibroscan liver stiffness after hepatitis C antiviral treatment was associated with the development of decompensated cirrhosis. The team of researchers analyzed data collected from United States veterans who initiated HCV treatment and had at least one liver stiffness before or after therapy. The team assessed whether that liver stiffness impacted the development of decompensated cirrhosis, Hepatocellular Carcinoma (HCC), or death. They concluded that there were no associations between pre-treatment liver stiffness and any adverse outcome. “In patients with HCV treated with anti-viral therapies, obtaining a post-treatment liver stiffness measurement may be beneficial in identifying patients at risk for long-term adverse outcomes,” George N. Iaonnou, MD, MS, of Veterans Affairs Puget Sound Healthcare System and colleagues wrote.

Chinese, Pakistani Companies To Jointly Set Up Cancer Precision Medical Laboratory
22 September 2020
Beijing Anlong Gene Medicine Technology Co., Ltd. and Life Rehealth Technology Pakistan Co., Ltd., will jointly establish a cancer precision medical laboratory in which the two companies will jointly carry out exploration and research on cancer medical treatment, and the Chinese company will also share its existing medical technologies with Pakistan. “Health knows no borders,” said Dr. Wei Yujun, general manager of Anlong Gene. “In recent years, China’s development in life sciences has attracted worldwide attention. As Chinese medical professionals, we have the responsibility to let cutting-edge technology benefit more groups. Pakistan is a friendly neighbor of China. Under the Belt and Road Initiative (BRI), we should also respond to policies and strengthen medical cooperation between friendly countries.”

Owlstone Medical Announces Key Study Results On Use Of Breath Biopsy For Improved Detection Of Liver Disease
22 September 2020
A recent patient study has reported to successfully demonstrate the use of exhaled limonene as a breath biomarker to measure liver function and stage liver disease. The positive results validate Owlstone Medical’s EVOC® probe strategy for the development of breath-based diagnostic and prognostic tests for Nonalcoholic Fatty Liver Disease (NAFLD) and associated Nonalcoholic steatohepatitis (NASH). In the study, exhaled breath from 32 cirrhosis patients and 12 cirrhotic hepatocellular-carcinoma patients were compared with 40 controls. Breath samples were analyzed by Owlstone Medical’s Breath Biopsy platform, from which the results demonstrated that limonene levels are associated with alterations in liver function. Limonene, therefore, holds great promise as a marker of liver metabolic capacity.

Roche's Tecentriq + Avastin Gets Positive Chmp Opinion for HCC
21 September 2020
The European Medicines Agency’s (EMA) Committee for Medicinal Products for Human Use (CHMP) has given a positive opinion to the combination of Tecentriq (atezolizumab), and Avastin (bevacizumab) for the treatment of adult patients with advanced or Hepatocellular Carcinoma (HCC). Tecentriq is already approved in the United States and the EU either alone or in combination with targeted therapies. The CHMP recommends the approval of the combination for HCC patients who have not received prior systemic therapy. The recommendation from the CHMP was based on results from the phase III IMbrave150 study, which showed that Tecentriq in combination with Avastin reduced the risk of death by 42% and the risk of disease worsening or death by 41% compared with Nexavar in patients with HCC.

Survival Improved With HAIC Over Standard TACE In Unresectable HCC
20 September 2020
A team of researchers found that patients experienced great improvement in overall survival (OS) with the addition of hepatic arterial infusion chemotherapy (HAIC) to oxaliplatin, fluorouracil, and leucovorin (FOLFOX) when compared with transarterial chemoembolization (TACE), as treatment of patients with unresectable Hepatocellular Carcinoma (HCC). The study was a phase 3, multi-center, open-label trial conducted in China, which included 315. TACE is the standard of care for patients with unresectable intermediate-stage HCC, and a previous phase II study demonstrated higher treatment response with HAIC with FOLFOX versus TACE, according to study author Ming Shi, MD, Ph.D., Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, in Guangzhou, China.

Tecentriq Opens Immune-Based Combo Therapy Era For Liver Cancer
21 September 2020
The combination of atezolizumab (Tecentriq) and bevacizumab (Avastin), as a treatment for Hepatocellular Carcinoma (HCC), is the first immune-based combo therapy that beat sorafenib according to the results of the IMbrace150 study. Compared to sorafenib, the combo treatment showed better overall survival (OS) and progression-free survival (PFS). Compared to sorafenib, the combo treatment showed better overall survival (OS) and progression-free survival (PFS). The results of PFS show that 55 percent of the combo group did not have progression at six months, versus 37 percent of the sorafenib group. “The most exemplary treatment option that prompted immune-based combo treatment for the first-line treatment of HCC was the use of Roche’s Tecentriq (atezolizumab), anti-PD-L1 immunotherapy, and Avastin (bevacizumab), a vascular endothelial growth factor (VEGF) inhibitor,” said Yu Su-jong of the Gastroenterology Department of the Liver Cancer Center at the Seoul National University Hospital (SNUH).

Cirrhotic Controls In A Pooled Analysis Of Hepatitis D And Hepatocellular Carcinoma
19 September 2020
Due to the lack of research on the link between Hepatitis D Virus (HDV) and Hepatocellular Carcinoma (HCC), a pooled analysis, which combines data from individual studies and analyses them as if derived from a single sample would be necessary. The team reported that coinfection with HDV was significantly associated with increased risk of HCC compared to infection with HBV alone. Cirrhosis and HCC are considered the final stages of HDV-associated liver disease.

Predicting Liver Cancer In People Cured Of Hepatitis C
16 September 2020
According to a set of studies, three new methods are using demographic characteristics, liver disease severity and readily available biomarkers to help predict who will develop liver cancer after having successful treatment for hepatitis C virus. chronic hepatitis C can lead to Hepatocellular Carcinoma (HCC), and although people who are cured of hep C are less likely to develop HCC, the risk is not eliminated. The studies included 3,929 people with chronic hepatitis C who were cured with direct-acting antiviral (DAA) treatments. Of the 2,829 patients with cirrhosis, 191 developed liver cancer, while only 15 of the 1,097 people with moderate to advanced fibrosis developed HCC. The researchers identified 11 variables associated with the development of HCC, including male sex, age greater than 64, hepatitis C virus (HCV) genotype 3, prolonged prothrombin time (a measure of blood clotting ability), and alpha-fetoprotein (AFP, a liver cancer biomarker).

Russian Scientists Have Developed An Optical Probe For The Diagnosis Of Liver Cancer
16 September 2020
If cancer is suspected in the liver, doctors will perform a percutaneous puncture biopsy, during which tissue samples are taken from the liver using a thick-needle or fine-needle aspiration needle. Scientists have created an optical biopsy method, which is performed using a special probe with a diameter of 1 mm. Doctors fix the probe in a biopsy needle, pass radiation through it, and a signal from the tissue is collected. This allows scientists to combine two existing optical technologies that are used to detect cancer. The first is fluorescence spectroscopy, designed to determine the difference in the glow of healthy and malignant tissues under the influence of laser radiation, and the second, diffuse reflectance spectroscopy, provides data on the absorption and scattering of light in tissues.

Priming With Tremelimumab Leads To Greater Efficacy For Durvalumab Treatment In Advanced HCC
16 September 2020
According to a presentation by Robin Kate Kelley, MD, associate professor, University of California, San Francisco, clinical activity was observed in Study 22, with a single priming dose of tremelimumab in combination with monthly durvalumab (Imfinzi) as treatment of patients with Hepatocellular Carcinoma (HCC) in the second line and beyond. The study showed that the combination had the most favorable efficacy, safety, and tolerability across all treatment arms in the study. In part 2A, the initial combination administered 75 mg of tremelimumab for 4 doses with 1500 mg of durvalumab every 4 weeks, but the new dosing schedule assessed in part 2B explored administration at 300 mg of tremelimumab once with the same durvalumab dose.

Ramucirumab Maintains Activity, Tolerability After Non-Sorafenib Frontline Therapy In HCC
15 September 2020
Findings from an interim analysis of a REACH-2 expansion cohort was consistent with data from the sorafenib-receiving intention-to-treat (ITT) population of phase 3 REACH-2 study to determine the safety and efficacy of ramucirumab (Cyramza) administered after a frontline, non–sorafenib (Nexavar)-based systemic therapy in Hepatocellular Carcinoma (HCC). The subgroup analysis showed that at a median follow-up of 6.5 months, the median progression-free survival (PFS) was 5.5 months. In previously reported data, at a median follow-up of 7.4 months, the median PFS was 2.8 months in the ITT population treated with ramucirumab versus 2.8 months in those treated with placebo. The primary endpoint of the open-label expansion (OLE) cohort evaluation was safety, with secondary endpoints including PFS, OS, overall response rate (ORR), and time to progression.

Dr. Kim On The Safety Profile Of Atezolizumab/Bevacizumab In HCC
14 September 2020
In May of this year, the FDA approved the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) as a first-line treatment for Hepatocellular Carcinoma (HCC). This approval was based on the findings from the phase 3 IMbrave150 trial, which reported a 42% reduction in the risk of death compared with sorafenib (Nexavar). A quality-of-life (QOL) analysis demonstrated that the combination did not compromise QOL for patients, says Richard D. Kim, MD, a medical oncologist within the Department of Gastrointestinal Oncology at Moffitt Cancer Center and an assistant professor of oncology with the University of South Florida College of Medicine. Fewer than 5% of patients experienced the risk of perforation or variceal bleeding with the combination treatment.

Cabozantinib Showcases Efficacy In Patients With HCC And Child-Pugh B
14 September 2020
Researchers conducted a retrospective analysis of data from the CELESTIAL trial which demonstrated the potential role for cabozantinib (Cabometyx) in patients with advanced Hepatocellular Carcinoma (HCC). Anthony B. El-Khoueiry, MD, explains that patients with Child-Pugh B liver cirrhosis are associated with poor prognosis. The CELESTIAL trial reported a median overall survival(OS) in patients treated with cabozantinib to be 10.2 months, versus 8.0 months for patients treated with the placebo, and the median progression-free survival (PFS) was 5.2 months, compared with 1.9 months, respectively. A total of 707 patients with advanced HCC and Child-Pugh A cirrhosis, which is the least severe, and who had received sorafenib (Nexavar) previously, and progressed following treatment. Overall, 10.3% of patients experienced deterioration due to Child-Pugh B cirrhosis in the first 8 weeks of the study.

Real-World Study Confirms Safety Of Regorafenib After Sorafenib In Unresectable HCC
14 September 2020
According to the ongoing prospective observational REFINE study regorafenib (Stivarga) demonstrated a tolerable safety profile as treatment of patients with Hepatocellular Carcinoma (HCC) in the real world. Most of the study population had received regorafenib as a second-line treatment with sorafenib (Nexavar) or other lines of therapy. Compared with the RESORCE study, the median overall survival (OS) was longer in patients who received regorafenib in the second-line setting after sorafenib. The median OS was 14.8 months among patients who received regorafenib in the second line after sorafenib. The median OS was 13.2 among those receiving regorafenib in any line, and 13.9 months among those who received regorafenib in any line after sorafenib. The median OS was 8.3 months for those receiving regorafenib in the third or later line.

Chemotherapy Drug More Effective When Combined With Microbubbles
8 September 2020
The common treatment of Hepatocellular Carcinoma(HCC) is transarterial chemoembolization (TACE), but doctors find that is it too imprecise to be a local drug delivery method. A team of researchers at Tulane University created a combination treatment called gas embolization, which involves vaporizing tiny droplets of perfluorocarbon, a common organic material composed of carbon and fluorine that is used in pharmaceuticals. Their study tested gas embolization alone and in combination with two common cancer drugs, doxorubicin (DOX) and tirapazamine. Gas embolization stops blood flow to the tumor and proved to be highly effective when used in combination with DOX. This method involves perfluorocarbon liquid to be administered intravenously, which then interacts with DOX that has been administered in the body. DOX binds to the surface of the droplets of liquid, which are small enough to travel through capillaries and do not cause blood vessel blockage until they are vaporized, so treatment can be applied at the specific site of the tumor.

Uptake Of Palliative Care In Liver Cancer Needs Improvement, Report Says
5 September 2020
Hepatocellular Carcinoma (HCC) is a cancer with a poor prognosis, increasing incidence, and one that carries a certain amount of stigma. The mortality-to-incidence ratio is 0.89. Early HCC rarely shows signs and leads to late diagnosis, with a 5‐year survival under 20%. A team of researchers found that palliative care is underused and referred too late. The main indications for referral were pain, end of life care, and nausea. For inpatients, the median time to death after consulting with palliative care was 3 days. The team also found that 81% of gastroenterologists believed the misconception that palliative care starts only when active therapy ends.

FDA Rejects Keytruda-Lenvima Combo As First-Line Treatment For Liver Cancer
4 September 2020
According to a press release, the FDA will not be approving the combination (pembrolizumab) plus Lenvima (lenvatinib) as a first-line treatment for people with advanced Hepatocellular Carcinoma (HCC). The decision was based on the findings from the Phase 1b KEYNOTE-524/Study 116 designed to assess the safety and effectiveness of the combination in patients with advanced HCC. The FDA determined that there wasn't enough evidence that this combination was meaningfully more effective than other approved treatments. The study found that patients lived a median of 8.6 months without signs of cancer progression, and their median overall survival was 22.6 months.

Immunotherapy Combinations Show Promise For Advanced Liver Cancer
2 September 2020
Checkpoint inhibitors are antibodies that help the immune system fight cancer. The three that show promise for patients with Hepatocellular Carcinoma (HCC) are Atezolizumab (Tecentriq), nivolumab (Opdivo) and pembrolizumab (Keytruda). The study including 336 people was conducted to test the efficacy of the combination of atezolizumab and bevacizumab. The research team concluded that atezolizumab plus bevacizumab “should be considered a new standard of care” for people with advanced liver cancer. Another study tested the efficacy of nivolumab plus ipilimumab. Of the 148 patients, the overall response rate was 29% among those who had taken sorafenib for six months or less and 36% among those who had used it longer. The respective median overall survival times were 19.2 and 25.5 months.

Lenvima Plus Keytruda Shows Promise For Advanced Liver Cancer
1 September 2020
According to a recent study led by Richard Finn, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, the combination of Lenvima (lenvatinib) and Keytruda (pembrolizumab) showed that 88% of participants either experiencing tumor remission or having stable disease. The study included 100 people with inoperable Hepatocellular Carcinoma (HCC). Lenvima is a multikinase inhibitor that targets VEGF receptors and enzymes that play a role in cancer cell growth and the development of blood vessels that feed tumors. Keytruda is a monoclonal antibody that blocks PD-1, an immune checkpoint on T cells that regulates immune function. The overall response rate (ORR) was 46%, and the median progression-free survival (PFS) time was 9.3 months.

New Data On Emerging Treatments For Liver Cancer Raise Hope For Advanced Disease Patients
28 August 2020
New treatment options for patients with advanced Hepatocellular Carcinoma (HCC) are now available. The IMbrave150 study investigated the combination of atezolizumab and bevacizumab versus sorafenib and showed improvements in overall survival (OS) and progression-free survival (PFS) with the combination therapy. The CheckMate 040 trial studied the efficacy and safety of nivolumab in combination with ipilimumab in three different dose combinations. The research showed that among 50 patients previously treated with sorafenib, the overall response rate was 32%, including four patients achieving a complete response, and the median OS was 22.8 months. This combination has been approved by the FDA as a second-line treatment after sorafenib.

Promising Data From Phase 1 Trial With ADP-A2AFP In Liver Cancer At The International Liver Congress Confirm Safety Profile And Demonstrate Potential Benefit For Patients
28 August 2020
“A complete response in a patient with advanced liver cancer, and the anti-tumor activity we have reported in other patients with an acceptable safety profile, to date, further support the continued investigation of ADP-A2AFP,” said Elliot Norry, Adaptimmune’s Chief Medical Officer. The Phase 1 trial of SPEAR T-cells targeting alpha-fetoprotein (AFP) showed one of the total of four patients with a dose of 5 billion or more transduced cells had a complete response. SPEAR® (Specific Peptide Enhanced Affinity Receptor) T-cell treatment platform enables the engineering of T-cells to target and destroy cancer across multiple solid tumors. The goal of Phase 1 clinical trial studies does escalation and will evaluate the safety and anti-tumor activity of ADP-A2AFP in patients with HCC who were intolerant to or refused standard-of-care treatment.

Stivarga, Opdivo Have Similar Survival Outcomes In HCC
27 August 2020
According to recent research, Stivarga (regorafenib, Bayer) and Opdivo (nivolumab, Bristol-Meyers Squibb) provided similar outcomes as second-line treatments for patients with Hepatocellular Carcinoma (HCC) who did not show a meaningful response using Retevmo. The team of researchers retrospectively evaluated 223 patients with HCC who were treated with regorafenib and 150 patients who were treated with nivolumab as a second-line treatment after sorafenib failure. The team found that progression-free survival (PFS), time to progression, and overall survival (OS) did not differ between the two groups of patients. “In the non-progressors, nivolumab showed significantly better survival outcomes compared with regorafenib, which is likely due to the durable responses of nivolumab,” stated Won-Mook Choi, of the department of gastroenterology at Asan Medical Center in South Korea.

New Models Help Predict Liver Cancer After Successful Hepatitis C Virus (HCV) Treatment
26 August 2020
Independent research teams from France and Egypt have been working on the ability to predict which patients may develop Hepatocellular Carcinoma (HCC) after successful treatment for chronic hepatitis C virus (HCV) infection. Using cohort studies of patients with chronic HCV infection who achieved a sustained virological response (SVR) to direct-acting antiviral (DAA) therapy, the teams set parameters to find those at the lowest and highest risk of developing HCC in the future, which could help to individualize HCC surveillance and detect HCC after HCV is cured as early as possible. Among patients who achieved SVR, the researchers identified two distinct types of patients at an elevated risk of developing HCC: one group with elevated serum parameters, and one group with impaired liver function.

Tips For Apps On Using TACE, TAE For Hepatocellular Carcinoma
25 August 2020
Research shows that the incidence of HCC in the United States is expected to continue to rise over the next 15 years. However only 10% – 15% of patients with Hepatocellular Carcinoma (HCC) have curative options at the time of diagnosis, and only 5% survive 5 years. Doctors discuss the difference between TACE vs. TAE treatments. Transarterial chemoembolization (TACE) is the standard of care for the intermediate-stage of disease. Ideal patients are those with single tumors. The goal of TACE is to improve quality of life, prolong survival and downstage the tumor for surgical resection. TACE is performed by accessing the femoral artery and directly injecting a chemotherapeutic agent such as mitomycin, cisplatin and doxorubicin. Transcatheter arterial chemoembolization (TAE) utilizes intravascular delivery of embolic microspheres to cut off the blood sully to the tumor without the delivery of chemotherapeutic agents. Controversies remain regarding TAE because it is not clearly established whether embolization has a comparable survival advantage to that of chemoembolization.

Drinking Two Cups Of Coffee A Day ‘Slashes Risk Of Dying From Liver Cancer By 46%
24 August 2020
Recent research, published in the Alimentary Pharmacology & Therapeutics journal, showed that two cups of coffee would reduce a person’s risk of dying from liver cancer by 46%. The team of researchers examined liver cancer-related deaths, finding that there were 1.2 million in 2016. Using data sets relating to coffee drinking, and a model that was able to reveal connections between coffee drinking and reductions in liver cancer, the team found that if every person in the world had consumed two cups of coffee a day in 2016, then there would have been 452,861 fewer deaths from liver cancer. It further concluded that if everyone had been drinking four cups a day, then there would have been 723,287 fewer deaths.

Tiziana Granted A Patent On The Use Of Milciclib In Combination With Tyrosine Kinase Inhibitors For Treatment Of Hepatocellular Carcinoma And Other Cancers
21 August 2020
The United States Patent and Trademark Office has granted a patent on the use of Milciclib in combination with tyrosine kinase inhibitors (TKIs) such as Sorafenib (Nexavar®), Regorafenib (Stivarga®) and Lenvatinib (Lenvima®) for the treatment of Hepatocellular Carcinoma (HCC). New combination therapies gain popularity and show promise as patients with HCC often develop resistance towards the monotherapies of existing therapeutics. It is thus an urgent need for combination drug treatment approaches targeting different mechanisms to achieve better clinical outcomes. Currently, the Phase 2a clinical evaluation of Milciclib, a broad-spectrum inhibitor of cyclin-dependent kinases, indicated that the treatment was well-tolerated, and produced positive clinical data in sorafenib-resistant patients of HCC. Another study of Milciclib in combination with Regorafenib, a specific TKI drug, in liver transplant patients with HCC recurrence showed that the combination treatment was safe and produced promising clinical responses in delicate and difficult to treat patients.

Rapid Progress In HCC Paradigm Shifts Standards, Sequencing Strategies
20 August 2020
As more advances and options become available for the treatment of patients with Hepatocellular Carcinoma (HCC), Bradley G. Somer, MD, an associate professor in the Department of Hematology and Medical Oncology at the University of Tennessee Health Science Center, explains that sequencing approaches will require careful consideration. Somer states, “HCC is a very complex disease. Many of these patients have underlying illnesses. However, new therapies [have emerged]. There is a new standard of care in the first-line setting based on data from the IMbrave150 trial. However, this also adds layers of complexity in terms of how to manage the next line of treatment.” Somer supports the combination of atezolizumab (Tecentriq) and bevacizumab (Avastin) as an excellent new standard of care.

Health Canada Grants Market Authorization For Tecentriq® In Combination With Vevacizumab, The First Immunotherapy Combination Treatment
19 August 2020
The Canadian, Health Canada has granted market authorization for Tecentriq (atezolizumab for injection), in combination with bevacizumab, for the first-line treatment of adult patients with Hepatocellular Carcinoma (HCC). This authorization is based on results from the randomized Phase III IMbrave 150 study, which showed that the combination of Tecentriq and bevacizumab reduced the risk of death by 42% and reduced the risk of disease worsening or death by 41% when compared with sorafenib. “I'm pleased that for the first time in over a decade I am able to offer patients a new therapy that data indicates can delay progression and improve overall survival in a more meaningful way for my patients,” stated Dr. Jennifer Knox, Staff Medical Oncologist, Princess Margaret Cancer Centre, Toronto.

Jiangsu Hengrui Gets Korea’s Green Light To Pursue Drug Combo In Phase III HCC Trial
18 August 2020
Jiangsu Hengrui Medicine Co. has been granted approval from Korea’s Ministry of Food and Drug Safety (MFDS) to begin a phase III trial for combination therapy of camrelizumab and rivoceranib. The study’s co-primary endpoint will be progression-free survival and overall survival. The randomized, open-label, international, multi-center trial will evaluate the safety and efficacy of the combination therapy vs. sorafenib in advanced or metastatic Hepatocellular Carcinoma (HCC) patients who have not received previous systematic treatment. Camrelizumab is a PD-1 inhibitor, a checkpoint inhibitor that blocks the activity of PD-1 (Programmed cell death protein 1), while rivoceranib is a VEGFR-2 inhibitor, a tyrosine kinase receptor inhibitor that reduces angiogenesis leading to anticancer activity. Jessie Zou, Jiangsu Hengrui’s chief medical officer, states “The combination of a PD-1/L1 antibody with a VEGFR inhibitor delivered a significant synergistic effect on efficacy, as well as safety, when used to treat HCC patients.”

Improved Outcomes With Cabozantinib In HCC Across All Baseline AFP Levels
14 August 2020
According to exploratory analysis of the phase 3 CELESTIAL trial, cabozantinib prolonged the survival of patients with previously treated advanced Hepatocellular Carcinoma (HCC), even among patients with high serum alpha-fetoprotein (AFP levels), according to exploratory analysis. The team found that among patients with lower baseline AFP levels, the median overall survival (OS) was 13.9 months with cabozantinib, while the group with higher AFP levels, resulted in a median OS of 8.5 months. Among patients with higher baseline AFP levels, the median progression-free survival (PFS) was 3.9 months. “Our analysis shows improved outcomes with cabozantinib relative to placebo in patients with previously treated HCC across a range of baseline AFP levels,” the authors wrote.

Dr. Kim On The Evolving Treatment Landscape Of Advanced HCC
14 August 2020
Richard D. Kim, MD, a medical oncologist within the Department of Gastrointestinal Oncology at Moffitt Cancer Center discusses how the treatment landscape of advanced Hepatocellular Carcinoma (HCC) remained largely unchanged since the approval of sorafenib (Nexavar) in 2007. However, the May 2020 approval of atezolizumab (Tecentriq) in combination with bevacizumab (Avastin) for patients with unresectable or metastatic HCC, based on findings from the IMbrave150 trial in which the combination elicited a 42% reduction in the risk of death compared with sorafenib, transformed the paradigm and introduced a new front-line standard of care, says Kim.

Ablative Therapy For Early HCC Reduces Mortality, Hospitalization Vs Surgery
14 August 2020
Constantinos T. Sofocleous, MD, Ph.D., Professor of Radiology, Weill Cornell Medical College, New York and Michael A. Choti, MD, Chief of Surgery, Banner MD Anderson Cancer Center, Gilbert, Arizona discuss the best course of treatment of early Hepatocellular Carcinoma (HCC). Choti argued in favor of surgery while Sofocleous advocated strongly for the use of ablative therapy. Although surgical hepatic resection (HR) has been shown to improve survival and disease-free survival over ablation, surgery has led to more complications and a higher rate of mortality than ablation. Thermal ablation will not impede future opportunities for surgery for disease recurrence in eligible patients.

How To Get More Cancer-Fighting Nanoparticles To Where They Are Needed
10 August 2020
Nanotechnology carriers are used to deliver drugs to cancer sites directly, which can help a patient's response to treatment and reduce adverse side effects. Unfortunately, in practice, few injected particles reach the tumor site. However, the University of Toronto Engineering researchers have discovered a dose threshold that greatly increases the delivery of cancer-fighting drugs into a tumor. The researchers discovered that injecting a baseline of 1 trillion nanoparticles in mice, in vivo, was enough to overwhelm the cells so that they couldn't take up particles quick enough to keep up with the increased doses. The result is a 12 percent delivery efficiency to the tumor. “The promise of emerging therapeutics is dependent upon our ability to deliver them to the target site,” explains Professor Warren Chan.

Addressing How To Treat Patients With Advanced Hepatocellular Carcinoma
7 August 2020
Mehmet Akce, MD, an assistant professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine begins with atezolizumab (Tecentriq) and bevacizumab (Avastin) in combination based on data from the IMbrave150 trial to treat patients with advanced Hepatocellular Carcinoma (HCC) in the first-line setting. As long as patients don’t have any conditions that were not studied in the trial, he feels comfortable using this combination in the frontline setting because it has been shown to be superior to sorafenib (Nexavar). Akce stresses that those with a liver tumor occupying more than 50% of their liver would not be suitable for this treatment.

Singal And Kim Talk Trials And Treatments For HCC
5 August 2020
Amit Singal, MD, MS, medical director, Liver Tumor Program Clinical Chief, Hepatology The University of Texas Southwestern Medical Center, and Richard Kim, MD, assistant professor, Oncology University of South Florida College of Medicine Moffitt Cancer Center discuss a case of a Hepatocellular Carcinoma (HCC). Singal explains that because this particular patient has good liver function, good performance status, and limited tumor burden, he would be eligible for curative treatments. Singal points out that there is a high risk of recurrence of about 70% at 5 years. Kim discusses the difference between lenvatinib, which has a more biochemical response and more tumor shrinkage, and sorafenib which is harder to tolerate.

UCLA Researchers Receive $2.97 Million Grant To Develop Test For Early Detection Of Liver Cancer
4 August 2020
A team of researchers led by Hsian-Rong “HR” Tseng, professor of molecular and medical pharmacology, and Dr. Vatche Agopian, director of Dumont-UCLA Liver Cancer Center were awarded a $2.97 million grant from the National Cancer Institute to develop a nanotechnology-enabled cancer diagnostic tool to help detect early-stage liver cancer for people who are at risk. The nanotechnology-enabled diagnostic technology, called EV Click Chips, is an effective extracellular vesicle purification system. It uses a multimarker cocktail to recognize, enrich and recover extracellular vesicles secreted from the Hepatocellular Carcinoma (HCC) tumor. This tool can be thought of as a liquid biopsy diagnostic approach, capable of noninvasive detection of early-stage HCC, which are usually undetectable using ultrasonography.

Phase 3 OPTIMA Trial In HCC To Continue To Follow Patients For OS
4 August 2020
Although there have been 26 consecutive patient deaths between September 2019 and March 2020 in the OPTIMA trial, Celsion Corporation will continue to follow patients with Hepatocellular Carcinoma (HCC). The phase 3 OPTIMA trial is currently examining ThermoDox® in combination with radiofrequency ablation for overall survival (OS). In the trial, patients were randomized to receive ThermoDox® in combination with standardized radiofrequency ablation, or standardized radiofrequency ablation alone. Overall survival is the primary endpoint of the trial, while the secondary endpoint is progression-free survival (PFS). Previous data from a retrospective analysis of 701 patients with HCC in the HEAT trial of ThermoDox® in combination with radiofrequency ablation showed an average 54% risk improvement in OS.

The Debate Continues: How To Treat Early-Stage HCC
4 August 2020
“As other cancers are becoming less common, HCC is actually becoming more common,” explains Thomas Karasic, MD, assistant professor of medicine at the University of Pennsylvania. Currently, only about one-third of HCC cases are found early. For those at risk for developing HCC, screening typically involves ultrasounds of the abdomen every 6 months, sometimes combined with a blood test for alpha-fetoprotein (AFP). Choosing the most appropriate course of treatment for the patient depends on the tumor characteristics. The preferred treatment approach is liver transplant if there are no more than three tumors, or the patient has cirrhosis and cannot safely undergo surgery or ablation. If the tumor is small, less than 3 cm, then ablation is usually done.

Shifting Liver Cancer Cells Away From Migratory State Could Reduce Their Drug Resistance
4 August 2020
According to new work from scientists at Fred Hutchinson Cancer Research Center and the University of Washington, whether a liver cancer cell is primed to grow or move affects its ability to resist cancer drugs. “We found new [molecular] players that are important in liver cancer and mediate resistance to therapy,” said Hutch systems biologist Dr. Taran Gujral, who co-led the project with Dr. Shao-En Ong at UW. “We found we can restore their sensitivity [to therapy] with drugs.” Dr. Gujral is an expert in the use of kinase inhibitors, treatments that involve molecules that block kinase activity, to untangle kinases’ roles in cellular processes. Dr. Ong had developed a method to measure protein abundance and activation state, while Dr. Golkowski and Dr. Chan combined their expertise to examine the role of kinases in drug resistance in HCC.

Sirtex Medical Launches State-Of-The-Art SIROS™ System For Advanced SIR-Spheres® Resin Microspheres Delivery
3 August 2020
Sirtex Medical has launched SIROS™, an innovative system for the delivery of SIR-Spheres® Y-90 resin microspheres. SIR-Spheres® Y-90 resin microspheres are tiny radioactive ‘beads' used in selective internal radiation therapy (SIRT), sometimes referred to as Y-90 radioembolization. The treatment consists of precisely formulated glass microspheres that are infused with high-dose Y-90 and are delivered with targeted accuracy into HCC tumors. SIROS™ offers a visual and versatile option for interventional radiologists to deliver SIR-Spheres® to patients with liver cancer. SIROS™’ design features a peel-and-place tubing set, a proprietary needleless D-Vial specifically designed to suspend SIR-Spheres® into a vortex allowing for a more even distribution, and a locking cover to safely secure the microspheres during delivery.

ISMETT Participates In Groundbreaking Liver Cancer Research
3 August 2020
A recent study led by Istituto dei Tumori in Milan with contributions from Dr. Salvatore Gruttadauria at ISMETT involved 74 patients diagnosed with nonmetastatic liver cancer and who had already received different therapies to reduce the size of their tumors. Patients were divided into two groups, those who underwent a liver transplant, and those who continued to be treated with non-surgical therapies. Five years following surgery, the research showed 76.8% of the transplanted patients were free from cancer and relapses, while only 18.3% of those who continued with traditional treatments survived. If traditional therapies, such as chemotherapy and radiation, do not result in sufficient improvements, patients can be put on the list for a liver transplant. “This is an excellent randomized clinical trial showing that cirrhotic patients with advanced Hepatocellular Carcinoma could have their tumors shrunk, allowing for liver transplantation and improved overall survival compared to those who did not have a transplant,” said Dr. David Geller, director of the UPMC Liver Cancer Center in Pittsburgh.

Archbold Offers New Therasphere Cancer Treatment
1 August 2020
Archbold Memorial Hospital’s Lewis Hall Singletary Oncology Center is working with Thomasville’s VITA Surgery and VITA Vascular, to offer patients diagnosed with liver cancer new therapy treatment. “Therasphere is internal radiation. We are able to inject the radiation directly into the tumor through a catheter that is placed in an artery that we can access from either the groin or the wrist. There’s no cutting, there’s no incision, and it’s done through a very small pinhole about two millimeters in size.” said Dr. Frederick Johnson, an interventional radiologist at VITA Surgery and VITA Vascular. This treatment is aimed for patients for whom surgery is not possible or patients with multiple tumors in both lobes of the liver who are not transplant candidates.

For past liver cancer news, please visit our Liver Cancer News Archives.

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