Liver Cancer News
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AMU Scientist, LA Prof Identify Protein Forming Cells Causing Tumour In Liver Cancer
20 June 2020
Agra: an AMU zoologist, Dr. Hifzur r Siddique, in coordination with Prof. Keigo Machida of the University of Southern Cal. LA, has discovered protein forming cancerous cells in the body causing the growth of tumor in the liver. It is either a result of alcohol consumption or hepatitis infection. Their research could be seen as a potential therapeutic target for the drug design and give a direction to the management strategy for this deadly disease. Siddique and Machida discovered the molecular mechanisms of a cancer-causing protein called TBC1D15. Siddique said, “Cancer stem cells are rare cells found in the tumor which are responsible for cancer initiation recurrence, indication and metastasis. Thus, these cells were considered as a root cause of almost all cancer.”
Dr. Huey On Challenges Faced With Immunotherapy In HCC
19 June 2020
Ryan W. Huey, MD, an assistant professor of the Department of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, discusses the challenges faced with immunotherapy in Hepatocellular Carcinoma (HCC). One such challenge in the HCC space, is a lack of tissue, and therefore the opportunity to find predictive biomarkers is less than it would be in other tumor types, explains Huey. Huey concludes that while some biomarkers in other diseases leave oncologists wanting for a bit more, they can help provide a signal for the rationale for immunotherapy, which is something that is not available in HCC.
Dual Checkpoint Regimen Buoys Prospects For Immunotherapy In HCC
18 June 2020
There has been a recent approval of nivolumab (Opdivo) in combination with ipilimumab (Yervoy) as dual immunotherapy for patients with Hepatocellular Carcinoma (HCC). Anthony B. El-Khoueiry, MD, was the lead author of the CheckMate 040 study, which led to the approval. Previously, the single-agent pembrolizumab was approved for patients with HCC who had been treated with sorafenib, based on results from the KEYNOTE-224 trial. The current study demonstrated the overall response rate (ORR) was 33%, with 4 complete responses (CRs) and 12 partial responses (PRs). The duration of response with the combination immunotherapy was 4.6 months to more than 30.5 months and 31% of responses lasted at least 24 months, thus showing a benefit to the nivolumab monotherapy.
Median Technologies: Ibiopsy®: Promising Results On A Preliminary Study To Evaluate The Risk Of Tumor Recurrence In Patients With Primary Liver Cancer
17 June 2020
Median Technologies has conducted a preliminary retrospective study on the evaluation of the risk of recurrence for patients with primary liver cancer, Hepatocellular Carcinoma (HCC), based on a non-invasive biomarker using The iBiopsy. Median’s iBiopsy® proprietary imaging platform allows for the extraction of non-invasive imaging biomarkers, which are the disease “signatures.” This was a two-part study involving 94 patients – first to accurately quantify liver fibrosis on CT images, and second, to correlate the score of fibrosis with the risk of recurrence in post-operative patients with HCC. The iBiopsy imaging biomarker discovery platform integrates advanced technologies in artificial intelligence to produce three-dimensional image results.
Patients With HCC Shoulder Economic Burdens, Have Insufficient Therapeutic Options
16 June 2020
A team of researchers led by Abdalla Aly, Ph.D., associate director of U.S. health economics and outcomes research at AstraZeneca, conducted two studies to better understand the toll of Hepatocellular Carcinoma (HCC) on patients living with the disease. First, they looked at rates of work absenteeism among patients living with HCC in the U.S. Considering 554 patients the team found that 78.5% had missed work, 47.7% had been on short-term disability, and 11.8% had been on long-term disability. They also reported that absenteeism among patients resulted in lost time worth $1,424 per patient per month. The team then conducted a review of existing scientific literature to see what it revealed about the economic and humanistic burden of the disease. Total treatment costs for payers and patients combined ranged from $11,913 to $16,947 per month.
Study Demonstrates Feasibility Of Hologram Technology In Liver Tumor Ablation
15 June 2020
In a recent study involving 5 patients has shown positive results in the use of augmented reality guidance with electromagnetically tracked tools, and that the technology may help doctors quickly, safely, and accurately deliver targeted liver cancer treatments. The patients were selected for microwave ablation of their liver tumors. The technology provides a three-dimensional holographic view inside a patient's body, allowing interventional radiologists to accurately burn away tumors while avoiding organs and other critical structures. Information is captured into a proprietary augmented reality application, which utilizes Microsoft's HoloLens technology, a virtual reality headset with transparent lenses, to project a segmented hologram of the patient's imaged anatomy directly onto the patient. Post-procedural imaging showed adequate tumor ablation, and none of the patients experienced tumor recurrence at the three-month follow-up.
The Talk: It’s Time To Move From Curative To Palliative Care
15 June 2020
Many physicians confess that they do not typically explain the difference between curative and palliative plans with their patients. Some physicians explain that they avoid discussing end of life planning so that the patient doesn’t get a sense of hopelessness. Palliative care aims to optimize the quality of life and avoid suffering in patients with terminal diseases. Curative care refers to the treatment of the disease. Blue Faery: The Adrienne Wilson Liver Cancer Assoc. team discussed Hepatocellular Carcinoma (HCC) care approaches with physicians, nurses, researchers, and patient advocates. Ineffective curative care robs the patient and their family of quality of life that palliative care may have afforded or enhanced. Doctors should make all options clear for their patients, including end-of-life planning and palliative care for the terminal.
Student-FACULTY Research Team Assessing Early Markers AND Dietary Treatment OF Liver Cancer
12 June 2020
An early indicator of metastatic Hepatocellular Carcinoma (HCC) is non-alcoholic Fatty Liver Disease (NAFLD). Associate Professor of Chemistry Angela Stoeckman is currently conducting research focused on understanding the dietary influence on markers of metastatic HCC. She explains that while hepatitis B and C are historically a common cause of liver cancer, those instances are decreasing because hepatitis immunizations are becoming more common. However, alcohol- and diet-related conditions are now being linked more strongly to liver cancer. A high-carbohydrate, high-fat diet—that’s especially high in high-fructose corn syrup—has been dubbed the “Western Diet.” NAFLD is a condition that impacts an estimated one in three Americans, and it can progress into HCC, the fastest-growing type of liver cancer globally.
Contrast-Enhanced MRI Shines Light On Liver Cancer Survival
11 Jun 2020
Sébastien Mulé, a radiologist from Henri Mondor University Hospital in Créteil, south-east of Paris, and colleagues have shown that hepatobiliary MR contrast agent uptake can predict survival in patients with Hepatocellular Carcinoma (HCC). The team found that in 32 patients the quantitative analysis of the hepatobiliary phase (HBP) tumor enhancement in gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI accurately identified microvascular invasion (MVI)-positive HCCs. When compared with dual-tracer 18F-FDG and 18F-fluorocholine PET/CT, the contrast-enhanced MRI method performed well for the prediction of tumor aggressiveness and recurrence-free survival (RFS). The team created a lesion-to-liver contrast enhancement ratio (LLCER) and found that an LLCER of -4.72% or less accurately identified patients with poor recurrence-free survival (RFS) after surgical resection.
NIH Scientists Develop Blood Test To Help Improve Liver Cancer Screening
11 June 2020
A team of researchers at the National Cancer Institute (NCI), have developed a new test that can help identify people who are likely to develop Hepatocellular Carcinoma (HCC). The test involves a simple blood test to check for the patient’s previous exposure to certain viruses. “Together with existing screening tests, the new test could play an important role in screening people who are at risk for developing HCC. It could help doctors find and treat HCC early. The method is relatively simple and inexpensive, and it only requires a small blood sample,” said the study’s leader, Xin Wei Wang, Ph.D., co-leader of the NCI Center for Cancer Research (CCR) Liver Cancer Program. The team reasoned that certain interactions between viruses and the immune system may raise the risk of developing HCC. People who have risk factors are recommended to get screened for HCC every six months with ultrasound with or without a blood test for alpha-fetoprotein.
Dr. Musher On Immunotherapy Versus TKIs In HCC
9 June 2020
Benjamin Leon Musher, MD, associate professor of medicine, hematology and oncology, Baylor College of Medicine, discusses immunotherapy versus TKIs in Hepatocellular Carcinoma (HCC). Tyrosine kinase inhibitors (TKIs) are a type of targeted therapy which are taken orally in the form of pills. Targeted therapy identifies and attacks specific types of cancer cells while causing less damage to normal cells. Immunotherapy is defined as a treatment or prevention of disease that involves the stimulation, enhancement, suppression, or desensitization of the immune system. Patients respond and sometimes tolerate TKIs better than immunotherapy. Immunotherapy may cause problems in patients with compromised liver function.
Genentech Gets FDA Approval For Tecentriq, Avastin Combo For HCC
1 June 2020
The US Food and Drug Administration (FDA) has recently approved Tecentriq (atezolizumab) in combination with Avastin (bevacizumab) for the treatment of Hepatocellular Carcinoma (HCC). Tecentriq and Avastin were both developed by Genentech, a subsidiary of Roche. Tecentriq is a monoclonal antibody designed to inhibit the PD-L1 protein expressed on tumor cells and tumor-infiltrating immune cells, while Avastin is a biologic antibody that can specifically bind to the VEGF protein to interfere with the tumor blood supply. The FDA approval was based on the findings of the phase 3 IMbrave150 study. The combination treatment showed an increase in overall survival (OS) by 42%, and progression-free survival (PFS) by 41%, in comparison to sorafenib. According to Genentech, the Tecentriq, Avastin combination is now the first cancer immunotherapy regimen to have been approved by the FDA for the treatment of HCC.
Ilson Explores Treatment Options For Patients With Metastatic HCC
1 June 2020
David H. Ilson, MD, Ph.D., medical oncologist, Memorial Sloan Kettering Cancer Center, New York, NY, discusses the treatment options for patients with Hepatocellular Carcinoma (HCC). The first line of treatment is liver resection if the patient’s liver is healthy enough. the REFLECT trial, involving 1000 patients, demonstrated that Lenvatinib was non-inferior to sorafenib in overall survival (OS), but also suggested better progression-free survival (PFS) for lenvatinib, better time to progression, and a higher response rate for lenvatinib over sorafenib. The IMbrave150 trial investigated first-line treatment with atezolizumab [Tecentriq] plus bevacizumab [Avastin], a PD-L1 inhibitor plus bevacizumab versus sorafenib in first-line treatment in 500 patients. The team presented a significant survival benefit for atezolizumab plus bevacizumab versus sorafenib. The 6-month OS rate was 85% for atezolizumab and bevacizumab versus 72% for sorafenib and showed over a 40% reduction in the risk of death. PFS was also improved with a median difference of about 2.5 months.
AZ Nabs A Positive Study For Imfinzi Plus Tremelimumab In Liver Cancer
31 May 2020
In a recent study, called Study 22, involving patients with advanced Hepatocellular Carcinoma (HCC), it was found that a single priming dose with AZ’s CTLA4 inhibitor tremelimumab, followed by PD-L1 inhibitor Imfinzi (durvalumab) given every four weeks, performed the best when compared to other treatment regimens. In Study 22, the tremelimumab/Imfinzi regimen achieved a median overall survival (OS) of 18.7 months. Kate Kelley of the University of California San Francisco (UCSF), the lead investigator in Study 22, said the data suggests that ‘priming’ the immune response with a CTLA4 inhibitor at the start of therapy induces a stronger response with Imfinzi. AZ is comparing the tremelimumab/Imfinzi regimen to standard first-line treatment with Bayer’s Nexavar (sorafenib) in the phase 3 HIMALAYA trial.
Updates In Combination Therapies For HCC
30 May 2020
Dr. Ghassan Abou Alfa, from Memorial Sloan Kettering Cancer Center in New York City, discussed current treatments for Hepatocellular Carcinoma (HCC). There have been several studies recently – one involving atlizumab, another the REFLECT study using lenvatinib, and the CheckMate 459 study looking at nivolumab. All three studies compared to sorafenib, the competitor. Researchers found that atlizumab performed better than the single-agent lenvatinib, and the single-agent nivolumab. Other therapies are the single-agent durvalumab, single-agent tremelimumab, tremelimumab plus durvalumab, at two different doses and frequencies. The best treatment found was the tremelimumab 300 single dose plus durvalumab regularly.
Single, Priming Dose Of Tremelimumab Plus Durvalumab Active In Second-Line Hepatocellular Carcinoma
30 May 2020
According to the findings of Robin Kate Kelley, MD, of the University of California, San Francisco the combination therapy of 300 mg tremelimumab plus durvalumab appeared to provide the best benefit-risk profile for the treatment of patients with Hepatocellular Carcinoma (HCC). The recent study included 332 patients with advanced HCC and randomly assigned them to single-agent durvalumab, single-agent tremelimumab, tremelimumab 300 mg plus durvalumab, or tremelimumab 75 mg plus durvalumab. The median overall survival (OS) was longest for the tremelimumab 300 mg plus durvalumab arm at 18.73 months. Treatment-related serious adverse events occurred highest with the tremelimumab monotherapy.
First-Line Donafenib May Be Superior To Standard Of Care In Advanced Hepatocellular Carcinoma
29 May 2020
Feng Bi, MD, PhD and team at the West China Hospital, Sichuan University, found that donafenib, a multikinase inhibitor, may be superior to sorafenib as first-line therapy for advanced Hepatocellular Carcinoma (HCC). The study included 668 patients with unresectable or metastatic HCC, where half received donafenib and the other half received sorafenib. The overall survival (OS) time in the group using donafenib was 12.1 months as compared to 10.3 months in the sorafenib group. The donafenib group also saw a 17% decreased risk of death. The team saw no significant difference in the median progression-free survival (PFS) time, 3.7 months in the donafenib group vs 3.6 months in the sorafenib group. “Donafenib significantly improves OS over sorafenib with favorable safety and tolerability,” the investigators concluded in their study abstract.
FDA Approves Atezolizumab Combo for Unresectable or Metastatic Hepatocellular Carcinoma
29 May 2020
Based on findings from the phase 3 IMbrave150 clinical trial, the FDA has approved the combination therapy atezolizumab (Tecentriq) plus bevacizumab (Avastin), as treatment of patients with unresectable or metastatic Hepatocellular Carcinoma (HCC). The study showed the combination reduced the risk of death by 42% as compared with sorafenib (Nexavar) alone. The study involved 336 patients who received the combination, and 165 patients who received only sorafenib. The objective response rate (ORR) was 27% with the combination versus 12% with sorafenib. The median time to response was 2.8 months with the combination vs. 3.3 months with sorafenib.
The First Step Toward Preventing Liver Cancer Is Being Aware Of The Precursors To Its Development
24 May 2020
The prevention of liver cancer may be in the hands of patients, and the risk can be reversible through dietary changes and exercise. By losing weight under a doctor's advice, patients may reverse the case of fatty liver they didn’t know they had, and potentially avoid cancer. Patients who are overweight, have symptoms of liver disease, have type 2 diabetes, drink alcohol regularly or have been exposed to hepatitis have a higher risk of liver cancer. When doctors find that a patient’s liver enzymes are elevated, they will follow-up with additional blood tests and imaging. While CT scanning is an option after hepatitis has been ruled out, a new approach is FibroScan, a specialized ultrasound device that vibrates the liver to measure stiffness due to scar tissue.
New Model Shows How Cells That Cause Liver Cancer Are Created
21 May 2020
Through several decades of research, doctors found that there is a subset of cells called cancer stem cells (CSCs) that function similarly to normal stem cells and cause cancer cells to form, renew, and proliferate. This means that if a tumor was removed but the CSCs were left alive, the CSCs would cause cancer to grow back. A team from Okayama University, led by Professor Masaharu Seno and Said Mohamed Abdelsabour Afify, has been able to develop CSCs from a type of normal stem cells by merely exposing them to what is believed to be favorable body environmental conditions, without introducing any mutations or foreign genes. “This is the world's first successful establishment of a liver CSC model from normal iPSCs without genetic manipulation,” Prof. Seno remarks. Normal induced pluripotent stem cells (iPSC), are a type of stem cell that can regenerate to develop into any type of human tissue, given the right conditions.
Dr. Parikh On The Role Of Radiation In HCC
20 May 2020
Radiotherapy is still an evolving field, in which most of the data are retrospective, explains Neehar Parikh, MD, medical director, Multidisciplinary Liver Tumor Clinic, Living Donor Liver Transplantation Program, assistant professor, Michigan Medicine, University of Michigan. Other treatments include stereotactic body radiotherapy (SBRT), chemoembolization, thermal ablation and surgical resection. SBRT administers very high doses of radiation, using several beams of various intensities aimed at different angles to precisely target the tumor and is thought to be safe and effective. Chemoembolization is performed by placing a small catheter from the blood vessel in your groin into the artery that supplies blood to the liver, resulting in a very highly concentrated dose of an anti-tumoral drug to be delivered.
‘Senolytic' Therapy Blunts Liver Tumor Progression In Animal Models
20 May 2020
According to new research from a team led by Celeste Simon, Ph.D., a professor of Cell and Developmental Biology in the Perelman School of Medicine at the University of Pennsylvania, a treatment called Senotherapy curbs liver tumor progression in animal models. Senotherapy is a treatment that uses small molecule drugs to target “senescent” cells or cells that no longer undergo cell division. Loss of the enzyme FBP1 in human liver cells significantly increases tumor growth and activates the neighboring hepatic “stellate cells,” which make up ten percent of the liver mass, causing tissue scarring and subsequent stellate cell senescence, both of which promote tumor growth. Using genetically engineered mouse models, the team eliminated FBP1and found the disease progressed more rapidly into forms of Hepatocellular Carcinoma (HCC).
Cabozantinib May Be A Match For Regorafenib In Second-Line Advanced HCC
19 May 2020
A recent study showed that Cabozantinib had a higher median progression-free survival (PFS) when compared with regorafenib as a second-line treatment of patients with advanced Hepatocellular Carcinoma (HCC). The team used results from two trials, the phase III CELESTIAL trial of cabozantinib versus placebo in 331 patients with HCC who received prior treatment with sorafenib, and the phase III RESORCE trial of regorafenib after sorafenib in HCC in 379 patients. The CELESTIAL trial showed the median overall survival (OS) was 10.2 months with cabozantinib versus 8.0 months with the placebo. Results from RESORCE showed higher alpha-fetoprotein (AFP) level response with regorafenib compared with the placebo. The median OS was 12.0 months in patients with an AFP response versus 7.0 months in those who did not achieve an AFP response.
New Drug Combo Could Improve Survival For Patients With Common Liver Cancer
18 May 2020
Results from a recent study show that the treatment combination of atezolizumab and bevacizumab improved survival by 42% for patients with Hepatocellular Carcinoma (HCC). The study included more than 500 patients, and at the 12-month check-in, survival rates were 67.2 % with atezolizumab/bevacizumab and 54.6% with sorafenib. “By using these two drugs with different mechanisms of action together, we have increased the number of patients who respond to this treatment and have increased the duration of these responses as compared to the standard treatment, sorafenib,” said the study's lead author, Richard S. Finn, MD, a professor of medicine at the David Geffen School of Medicine at UCLA. Atezolizumab is an immunotherapy drug that increases the body's natural defenses, and bevacizumab is an antiangiogenesis drug that suppresses the growth of a tumor's blood vessels.
People Infected With Hepatitis D Are More Prone To Hepatocellular Carcinoma
18 May 2020
Of the 5 types of Hepatitis viruses, Hepatitis D, which can only infect people already infected with Hepatitis B, is one of the most dangerous forms of chronic viral hepatitis because of its possible progression to irreversible liver diseases. Based on a retrospective study a team of researchers, led by Francesco Negro, Professor at the Department of Pathology and Immunology of UNIGE Faculty of Medicine and Head of the HUG Viropathology Unit. found that people infected with Hepatitis D have up to three times the risk of developing Hepatocellular Carcinoma (HCC) compared to those infected only with Hepatitis B. There is currently no treatment for Hepatitis D, aside from interferon, an antiviral and an immuno-modulator which shows minimal effectiveness but has deleterious side effects.
Tiziana Life Delighted With Data From Liver Cancer Treatment Trials In Italy
14 May 2020
Tiziana Life Sciences has received positive clinical trial data for its liver cancer treatment Milciclib from two clinical trials in The Granda Ospedale Maggiore Policlinico in Milan, Italy. A Phase 2a clinical trial with orally administered Milciclib in sorafenib-resistant Hepatocellular Carcinoma (HCC) patients met the primary endpoint of being well tolerated with manageable toxicities and no recorded drug-related deaths. The study has shown mean AFP levels (a common tumor biomarker) reduced by approximately 20% within one month of treatment. Prof. Angelo Sangiovanni, the principal investigator, said, “The fact that many of the treated patients continued with the treatment, even after completing 6 months duration of the study, is particularly very impressive.”
Personalized Treatment For Subtypes Of HCC Is The Way Of The Future
13 May 2020
The use of new genomic technologies, involving the study of the genetic material of an organism, has made it possible for researchers to identify many subtypes of Hepatocellular Carcinoma (HCC). More research is necessary to identify which patients may respond best to certain treatments, such as immunotherapeutic agents and combinations of others. Yujin Hoshida, MD, Ph.D., associate professor of internal medicine, University of Texas Southwestern Medical Center, states “That may be the place to start to link with specific drug therapies because this way of looking at liver cancer may be an efficient way to identify the potential specific drugs for a specific patient rather than chasing one single target at one at a time for each drug.”
New Treatment Extends Lives Of People With Most Common Type Of Liver Cancer
13 May 2020
Researchers found that the combination of atezolizumab, an immunotherapy drug that boosts the body's natural defenses, and bevacizumab, an anti-angiogenesis drug that inhibits the growth of tumors' blood vessels, improved overall survival, reduced the risk of death by 42%, and decreased the risk of the disease worsening by 41% in patients with Hepatocellular Carcinoma (HCC). Atezolizumab and bevacizumab are monoclonal antibodies, which means that they are specialized drugs that attach themselves to specific proteins and disable them. The lead author of the study is Dr. Richard S. Finn, a professor of medicine at the David Geffen School of Medicine at UCLA.
Team-Based Approach Essential In HCC Care
12 May 2020
Neehar Parikh, MD explains that a multidisciplinary team is critical in the treatment of patients with Hepatocellular Carcinoma (HCC), and has demonstrated a survival advantage as compared with single-provider care. This multidisciplinary group includes hepatologists, interventional radiologists, medical oncologists, diagnostic radiologists, and palliative care physicians. “HCC is a unique malignancy in that multidisciplinary care has been shown to improve outcomes,” said Parikh. “Every patient diagnosed with HCC deserves to know whether they are a candidate for transplant, so they can proceed with [their] treatment.” Transplant is associated with the best outcome, regardless of which patient populations are observed.
Racial Inequalities Of Liver Cancer Mortality Increase After Introduction Of Hepatitis C Drugs
11 May 2020
According to a recent study from Florida Atlantic University's Schmidt College of Medicine and Baylor College of Medicine, racial inequalities of the mortality rate from liver cancer in the United States has steadily increased from 1998-2016 after the introduction of lifesaving drugs for the hepatitis C virus in 1998. Of the 16,770 deaths from liver cancer among black patients, the excess relative to white patients increased from 27.8% to 45.4% during the period from 1998-2016. The mortality rates among black patients over 55 by 1.7% per year from 1997 to 1997 and 4.7% per year from 2000 to 2016. As opposed to the mortality rate for white patients of this age range from 1979 to 1990 increased by 3.5% per year and only 2% per year from 1990-2016.
Fewer Women Receive Liver Transplants Than Men
11 May 2020
More than a decade of research shows that women in the United States with cirrhosis are less likely to receive a liver transplant, and more likely to die on the waitlist, than men. Shortly after the new Model for End-Stage Liver Disease (MELD) score system for liver transplantation was adopted in 2002, the transplant community noticed a persistent disadvantage for women who needed access to a liver transplant compared with men, explained Elizabeth Verna, MD, transplant hepatologist and gastroenterologist at New York-Presbyterian/Columbia University Irving Medical Center, in New York City. Verna and the team performed a prospective study of 90,720 registrants with the Organ Procurement and Transplantation Network (OPTN) database found that women were 20% less likely to be transplanted than men, and women had higher mortality than men four years after listing.
Researchers Reveal Why Liver Cancer Patients React Poorly To Immunotherapy
7 May 2020
Liver cancer is one of the five most common cancers in Korea. Patients with advanced liver cancer tend to show poor prognosis as they tend to have tolerance against anticancer, radiation, and targeted therapy. The “cancer stem cells” are known as a major problem that resists to various treatments. The research team at Seoul St. Mary's Hospital confirmed that the expression of the carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) on the cell surface, with high expression of epithelial cell adhesion molecule (EpCAM), increased to avoid immune mechanisms caused by tumor killer cells, such as natural killer cells. The CEACAM1 expression in liver cancer stem cells that manifests EpCAM interferes with the tumor killer cells and keep them from working properly, reducing the immunotherapy’s effect to half.
Locoregional Therapies Remain A Key Element Of Care In HCC
07 May 2020
Currently, there are many treatments available for patients with Hepatocellular Carcinoma (HCC). Riad Salem, MD, a professor and chief of Vascular Interventional Radiology in the Department of Radiology at Northwestern University Feinberg School of Medicine explains that treatments include surgical resection, transplantation, ablation, stereotactic body radiotherapy (SBRT), and embolization, but that a multidisciplinary team is needed to determine the optimal use of these approaches. Many patients can benefit from a combination of treatments. Salem states, “For some patients, [local therapy] can postpone toxic systemic therapy. By combining [therapy in this manner], we can optimize [the patient’s care] and expose them to all of the agents they would be good candidates for.”
FDA Grants Orphan Drug Designation To First Liver-Targeted Drug For HCC
6 May 2020
Medivir's MIV-818 has been granted Orphan Drug Designation by the FDA for the treatment of patients with Hepatocellular Carcinoma (HCC). This US designation follows an Orphan Medicinal Drug Designation in Europe for the same indication. The current phase Ib study will determine the safety and preliminary efficacy of MIV-818 in patients with liver cancer. Medivir states that the drug has the potential to become the first liver-targeted, oral drug available to patients with HCC. In early March, Medivir announced that the first liver cancer patient was dosed with MIV-818 in the study. Thus far, 5 out of 9 patients had stable disease following treatment with MIV-818. Uli Hacksell, Ph.D., CEO at Medivir, stated, “Patients with advanced liver cancer have limited treatment options and the unmet medical need is large,”
Evidence Supports Efficacy, Safety Of Sorafenib In Older Hispanic Patients With Advanced HCC
17 April 2020
The frequency of Hepatocellular Carcinoma (HCC) has been shown to increase with increasing age across different populations with a peak age of 70 years, and US Hispanic patients have the second-highest rates after the Asian patients. A team of researchers conducted a retrospective analysis of Hispanic patients with HCC and found that there is no significant difference in median overall survival (OS) for older compared with younger patients. The study included statistics from 118 patients with 87 patients younger than 65 and 31 were 65 and older., with each group comprised of more than 70% Hispanic. The team found that the median progression-free survival (PFS) was 4.6 months and the median overall survival (OS) was 10.2 months for the younger group, and for the older group median PFS was 6.2 months and median OS was 13.5 months. Additionally, the median OS was 11.2 months for Hispanic patients vs 8.7 months for non-Hispanic whites.
A New Treatment For Liver Cancer
17 April 2020
Dr. Timofei Zatsepin of Skoltech and a team of researchers from MIT have a new treatment option for liver cancer. Using a siRNA approach, with lipid nanoparticle technology developed in the Anderson laboratory of MIT, the scientists targeted proteins that are involved in apoptosis, a regulated program for cell death. The team notes that only recently, multiple kinase-inhibitor regorafenib and two different check-point inhibitors were approved for patients who progress after sorafenib, but this only increased the overall survival (OS) by 3 months. “Once the mechanism is turned off, the cells become more susceptible to dying. This allows for the chemotherapy to be more efficient, killing more cancer cells, and preventing them from dividing. And although our siRNA reaches all liver cells, the cancer cells are more sensitive, because they are dividing rapidly, so they will be more affected by the treatment whereas normal cells survive,” explained Dominique Leboeuf, Skoltech Ph.D. These results are the tireless effort of a long-lasting collaboration between Skoltech and MIT, led by professors Konstantin Piatkov, Timofei Zatsepin and Daniel Anderson.
Studies Investigate Multiple Types Of Therapies In HCC
16 April 2020
There are currently many therapy and trial options for patients with Hepatocellular Carcinoma (HCC), as explained by Michael R. Charlton, MD, MBBS, professor of Medicine, director of the Center for Liver Diseases, and co-director of the Transplant Institute at the University of Chicago Medicine. He explains that many drugs are used in combinations for higher effectiveness, such as cabozantinib (Cabometyx) being used with the checkpoint inhibitor nivolumab (Opdivo). He mentions the IMbrave150 trial, which investigated bevacizumab (Avastin) and the checkpoint inhibitor atezolizumab (Tecentriq) in combination. Charlton and colleagues agreed that having guidelines that are actively being updated, so they reflect data as they emerge instead of waiting 1 or 2 years for the field to agree that using a specific regimen is the correct thing to do.
Regular Exercise Could Help Prevent Liver Cancer
15 April 2020
A team of researchers has found that regular exercise activates a gene that suppresses tumor growth of the most common type of liver cancer called Hepatocellular Carcinoma (HCC). The study was performed using mouse models. The team genetically modified the mice causing them to over-eat, become obese and develop type 2 diabetes. The mice were also previously injected with a cancer-causing agent. Half of the mice were allowed regular access to a running wheel, and ran up to 40 kms a day, while the other half were not and remained sedentary. Although the running mice slowed their weight gain, by six months into the experiment, even the running mice were obese. The team observed that at the 6-month mark most of the sedentary mice had liver cancer while none of the exercising mice had developed it.
Sequencing Targeted Therapies And Immunotherapies In Hepatocellular Carcinoma
15 April 2020
The frontline treatment options for patients with Hepatocellular Carcinoma (HCC) include sorafenib (Nexavar) and lenvatinib (Lenvima). Regorafenib (Stivarga), cabozantinib (Cabometyx), and ramucirumab (Cyramza) are all FDA-approved as second-line, or future, treatments. Patients can also receive nivolumab (Opdivo) and pembrolizumab (Keytruda) as follow-up treatments. Doctors agree that the sequencing of treatments remains an important topic in the treatment landscape of HCC. According to Lipika Goyal, MD, “Immunotherapies are available as well and are useful in select patient populations, such as those who rapidly progressed on the tyrosine kinase inhibitors (TKIs) sorafenib or lenvatinib, had poor tolerability of the agents, or are unable to receive third-line therapy.” Goyal goes on further to explain that single-agent immunotherapy after someone has already received atezolizumab is unlikely to be effective and encourages these patients to consider enrolling in clinical trials.
Immunotherapy Combinations Emerge As Likely Standard For Future HCC Management
14 April 2020
According to the phase III IMbrave150 study, the combination of PD-L1 and VEGF inhibition may be a treatment for Hepatocellular Carcinoma (HCC). The trial examined the combination of atezolizumab (Tecentriq) plus bevacizumab (Avastin) versus sorafenib (Nexavar). The study included 501 patients with unresectable HCC who were randomly assigned to 1200 mg of intravenous (IV) atezolizumab plus 15 mg/kg of IV bevacizumab every 3 weeks or 400 mg of sorafenib twice daily. The median progression-free survival (PFS) was 6.8 months in the atezolizumab/bevacizumab arm and 4.3 months in the sorafenib arm. The median overall survival (OS) was not reached in the atezolizumab/bevacizumab arm versus 13.2 months in the sorafenib arm.
The Future Of HCC Management
9 April 2020
Ghassan K. Abou-Alfa, MD, MBA discusses with several doctors the future of care for patients with Hepatocellular Carcinoma (HCC). He believes that understanding the etiologies, or the causes, is especially important as well. Ahmed Kaseb, MD explains that is it important for the care team to know how strong both the patient and the liver are before beginning a course of treatment. The next step is to personalize the treatment and choose a combination of therapy and create the appropriate sequencing. Anthony B. El-Khoueiry, MD believes that HCC is a broad disease where the use of biomarkers is key and the breakdown of the molecular subgroups.
Real-Life Analysis Of Nivolumab In Patients With HCC Align With Clinical Trial Data
7 April 2020
Researchers emphasize the importance of early diagnosis and appropriate management of Hepatocellular Carcinoma (HCC), based on the data of a real-life cohort of patients receiving nivolumab (Opdivo). The study reviewed 118 patients from 10 institutions in Spain, with the most common adverse effects including hepatitis C (57.1%) and hepatitis B (11.9%). Corticosteroids were used for the management of most adverse effects. Nivolumab was used as frontline therapy in 7 patients, second-line in 20 patients, and third-line in 15 patients. At the last follow-up assessment, 25 patients remained alive, including 24 patients who continued to receive nivolumab, 17 patients had died, and 17 patients discontinued due to disease progression.
Shenogen Enters Into An Exclusive License With Bioardis To Develop And Commercialise FGFR4 Kinase Inhibitor For Asian Market
6 April 2020
Shenogen and BioArdis have joined into a collaboration and licensing agreement for the development and commercialization of BioArdis' FGFR4 (fibroblast growth factor receptor 4) kinase inhibitor, BIO-1262/SNG-203, to be used as a monotherapy or combination therapy. BIO-1262 is being evaluated as a potential new treatment for Hepatocellular Carcinoma (HCC). Fibroblast growth factor receptors (FGFRs) play a key role in regulating cell survival and growth, and many recent studies suggest that they also play a role in cancer progression. Dr. Meng Kun, chairman of Beijing Shenogen Pharmaceutical Group, states, “Icaritin from Shenogen is currently in late-stage of phase III clinical trials for the treatment of advanced Hepatocellular Carcinoma (HCC) as a single agent and in combination therapies. The addition of clinical development of BIO-1262/SNG-203 will strategically solidify our company’s leading position in the field of Hepatocellular Carcinoma treatments.”
Yiviva Announces Dosing Of First Patient In Phase 2b Study Of First-Line YIV-906 Plus Sorafenib Combination Therapy In The Treatment Of Hepatocellular Carcinoma
6 April 2020
Yiviva, a clinical-stage biotechnology company developing multi-target botanical therapeutics using a systems biology approach, has dosed their first patient sin their Phase 2b study of YIV-906 in combination with sorafenib in the treatment of patients with hepatitis B-positive Hepatocellular Carcinoma (HCC). YIV-906 is a therapeutic candidate made up of a proprietary cGMP botanical extract of four herbs which are inspired by a traditional Chinese medicine formulation used for over a millennium. Yiviva shows that YIV-906 may have the ability to enhance the anti-tumor activity of sorafenib, protect cells of the gastrointestinal tract, and enhance natural and adaptive immune function. The clinical study is looking to enroll 125 patients within 20 sites in the U.S., mainland China, Hong Kong, and Taiwan.
MRI Identifies Biomarkers For Aggressive HCC Subtype
3 April 2020
According to a recent study, a team of French researchers has discovered three important biomarkers to heighten the pre-operative detection of the macrotrabecular-massive subtype, an aggressive form of Hepatocellular Carcinoma (HCC). Led by Dr. Sébastien Mulé, Ph.D., from Henri Mondor University Hospital in Créteil, the team performed a retrospective study to analyze 152 patients who pre-operatively underwent a liver scan. All the patients had one HCC lesion, which was removed with surgical resection. Among them, the MRI identified 26 macrotrabecular-massive HCCs. The existence of substantial necrosis, high serum alpha-fetoprotein (AFP) levels, and a more advanced stage of liver cancer were independently associated with macrotrabecular-massive HCC.
FDA Approves Immunotherapy Combination For Liver Cancer
1 April 2020
Based on results from the Phase I/II CheckMate 040 trial, the FDA approved the combination of checkpoint inhibitors Opdivo (nivolumab) and Yervoy (ipilimumab) for people with advanced Hepatocellular Carcinoma (HCC). The trials showed a response rate of 33% among HCC patients who had been previously treated with Nexavar (sorafenib), a tyrosine kinase inhibitor, which is typically a standard first-line treatment. Opdivo is a PD-1 checkpoint inhibitor that helps the immune system fight against cancer cells. Yervoy is a different type of checkpoint inhibitor that blocks CTLA-4, which turns off immune responses by suppressing T-cell replication.
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