In the Journals

Liver cancer risks, detection: 8 recent reports

Patients with liver disease such as viral hepatitis and nonalcoholic fatty liver disease with cirrhosis are at increased risk for progression to hepatocellular carcinoma, which can also lead to extrahepatic cancer. Researchers have recently published new data on factors that improve early detection and diagnosis, as well as defining risks prior to HCC and during treatment.

Healio presents the following recent reports that include studies on ethnic differences in liver cancer detection, improved diagnosis with bi-annual screening, and innovative noninvasive testing solutions.

Ethnic differences determine liver cancer detection, outcomes

Researchers determined racial and ethnic differences that correlated with early detection of hepatocellular carcinoma and receipt of curative treatment, which could be used as intervention targets to improve patient outcomes.

“As with most malignancies, HCC tumor burden at diagnosis impacts both prognosis and treatment decisions,” Nicole E. Rich, MD, from the University of Texas Southwestern Medical Center, and colleagues wrote. “Understanding and quantifying potential differences is the first step to identify intervention targets and inform strategies to reduce existing disparities. Read more

Bi-annual liver cancer screening for cirrhosis improves diagnosis, survival

Compliance with hepatocellular carcinoma surveillance correlated with early diagnosis, better allocation of curative treatment and longer overall survival among patients with hepatitis C- or hepatitis B-associated compensated cirrhosis, according to a recently published study.

“Monitoring for HCC in patients with cirrhosis, based on bi-annual ultrasound examination is recommended by international guidelines,” Charlotte Costentin, MD, from the Hôpital Henri Mondor in France, and colleagues wrote. “Improving compliance with surveillance guidelines should translate into a significant improvement in the prognosis of this deadly cancer.” Read more

Pediatric liver cancer may lead to brain metastases

Fibrolamellar hepatocellular carcinoma, a rare childhood liver cancer, metastasized to the brain, prompting researchers to recommend surveillance neuroimaging for patients with advanced disease, according to published findings.

“Current treatment for fibrolamellar hepatocellular carcinoma focuses on gross total resection, as systemic therapy remains unstandardized,” Sanford M. Simon, PhD, professor at the Laboratory of Cellular Biophysics at The Rockefeller University, and colleagues wrote. “However, fibrolamellar hepatocellular carcinoma is frequently diagnosed at an advanced stage, and the majority relapse within 1 year despite resection. ... Reports of two patients with brain metastasis exist in the literature but neither provides neuroimaging, pathologic or molecular analysis of the lesions.” Read more

Plasma assay of methylated DNA markers detects liver cancer

In this exclusive video perspective from Digestive Disease Week 2018, John B. Kisiel, MD, a gastroenterologist from the Mayo Clinic in Rochester, Minn., shares results of a study in which plasma assay of methylated DNA markers detected hepatocellular carcinoma across all stages.

“These are markers we discovered as part of a larger set in an experiment that sequenced DNA extracted from frozen tissue specimens from patients at Mayo Clinic,” Kisiel told Healio Gastroenterology and Liver Disease. “The aim of the present study was to validate these markers in a larger cohort that included a spectrum of stages of disease, including early-stage patients who would be potentially curable.” Watch here

Exact Sciences expands noninvasive cancer testing in the GI space

In this exclusive industry perspective from Digestive Disease Week 2018, Kevin Conroy, CEO of Exact Sciences, discusses the company’s noninvasive Cologuard colon cancer test and recent data on a new noninvasive test for the detection of liver cancer.

“Exact Sciences’ mission is to help play a role in the eradication of colon cancer,” Conroy told Healio Gastroenterology and Liver Disease. “We developed Cologuard, which is a noninvasive stool DNA test that is the first and only stool DNA test approved by the FDA. It’s been used to screen over 1.1 million people in the U.S., and over 110,000 physicians use Cologuard.” Watch here

Stivarga improves HCC outcomes in cases of progression during Nexavar therapy

Stivarga therapy provided clinical benefit to patients with hepatocellular carcinoma and had similar adverse event rates regardless of the last Nexavar dose or time-to-progression on prior Nexavar therapy, according to a recently published study.

Richard S. Finn, MD, from the David Geffen School of Medicine at the University of California Los Angeles, and colleagues conducted a retrospective analysis of the RESOURCE trial — the results of which showed Stivarga (regorafenib, Bayer) significantly improved overall survival in patients whose HCC progressed during Nexavar (sorafenib, Bayer) therapy — to verify the outcomes of sequential treatment with sorafenib followed by regorafenib. Read more

Abstinence does not reduce HCC risk in alcoholic-related cirrhosis

Alcohol abstinence did not reduce the risk for hepatocellular carcinoma among patients with Child-Pugh class A or B alcohol-related cirrhosis, according to a presentation at the International Liver Congress 2018.

“Our goal was to investigate if abstinence reduces HCC risk in a series of patients with alcoholic liver cirrhosis who were included in an HCC surveillance program,” Andrés Castano-Garcia, MD, PhD, from the Hospital Universitario Central de Asturias in Spain, said in his presentation. “Abstinence was defined as the absence of any alcohol consumption from inclusion and established based on interviews with patients.” Read more

Novel score predicts liver cancer risk during HBV antiviral therapy

Researchers developed a predictive risk score for the development hepatocellular carcinoma during oral antiviral therapy in patients with chronic hepatitis B, according to recently published data.

“The score requires simple information that is readily available in all treated patients,” Yao-Chun Hsu, MD, from the Fu-Jen Catholic University, Taiwan, and colleagues wrote. “By stratifying patients at different risks of HCC, the easily applicable score may inform the clinical practice and healthcare policy in the era of antiviral treatment for [chronic HBV].” Read more

Patients with liver disease such as viral hepatitis and nonalcoholic fatty liver disease with cirrhosis are at increased risk for progression to hepatocellular carcinoma, which can also lead to extrahepatic cancer. Researchers have recently published new data on factors that improve early detection and diagnosis, as well as defining risks prior to HCC and during treatment.

Healio presents the following recent reports that include studies on ethnic differences in liver cancer detection, improved diagnosis with bi-annual screening, and innovative noninvasive testing solutions.

Ethnic differences determine liver cancer detection, outcomes

Researchers determined racial and ethnic differences that correlated with early detection of hepatocellular carcinoma and receipt of curative treatment, which could be used as intervention targets to improve patient outcomes.

“As with most malignancies, HCC tumor burden at diagnosis impacts both prognosis and treatment decisions,” Nicole E. Rich, MD, from the University of Texas Southwestern Medical Center, and colleagues wrote. “Understanding and quantifying potential differences is the first step to identify intervention targets and inform strategies to reduce existing disparities. Read more

Bi-annual liver cancer screening for cirrhosis improves diagnosis, survival

Compliance with hepatocellular carcinoma surveillance correlated with early diagnosis, better allocation of curative treatment and longer overall survival among patients with hepatitis C- or hepatitis B-associated compensated cirrhosis, according to a recently published study.

“Monitoring for HCC in patients with cirrhosis, based on bi-annual ultrasound examination is recommended by international guidelines,” Charlotte Costentin, MD, from the Hôpital Henri Mondor in France, and colleagues wrote. “Improving compliance with surveillance guidelines should translate into a significant improvement in the prognosis of this deadly cancer.” Read more

Pediatric liver cancer may lead to brain metastases

Fibrolamellar hepatocellular carcinoma, a rare childhood liver cancer, metastasized to the brain, prompting researchers to recommend surveillance neuroimaging for patients with advanced disease, according to published findings.

“Current treatment for fibrolamellar hepatocellular carcinoma focuses on gross total resection, as systemic therapy remains unstandardized,” Sanford M. Simon, PhD, professor at the Laboratory of Cellular Biophysics at The Rockefeller University, and colleagues wrote. “However, fibrolamellar hepatocellular carcinoma is frequently diagnosed at an advanced stage, and the majority relapse within 1 year despite resection. ... Reports of two patients with brain metastasis exist in the literature but neither provides neuroimaging, pathologic or molecular analysis of the lesions.” Read more

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Plasma assay of methylated DNA markers detects liver cancer

In this exclusive video perspective from Digestive Disease Week 2018, John B. Kisiel, MD, a gastroenterologist from the Mayo Clinic in Rochester, Minn., shares results of a study in which plasma assay of methylated DNA markers detected hepatocellular carcinoma across all stages.

“These are markers we discovered as part of a larger set in an experiment that sequenced DNA extracted from frozen tissue specimens from patients at Mayo Clinic,” Kisiel told Healio Gastroenterology and Liver Disease. “The aim of the present study was to validate these markers in a larger cohort that included a spectrum of stages of disease, including early-stage patients who would be potentially curable.” Watch here

Exact Sciences expands noninvasive cancer testing in the GI space

In this exclusive industry perspective from Digestive Disease Week 2018, Kevin Conroy, CEO of Exact Sciences, discusses the company’s noninvasive Cologuard colon cancer test and recent data on a new noninvasive test for the detection of liver cancer.

“Exact Sciences’ mission is to help play a role in the eradication of colon cancer,” Conroy told Healio Gastroenterology and Liver Disease. “We developed Cologuard, which is a noninvasive stool DNA test that is the first and only stool DNA test approved by the FDA. It’s been used to screen over 1.1 million people in the U.S., and over 110,000 physicians use Cologuard.” Watch here

Stivarga improves HCC outcomes in cases of progression during Nexavar therapy

Stivarga therapy provided clinical benefit to patients with hepatocellular carcinoma and had similar adverse event rates regardless of the last Nexavar dose or time-to-progression on prior Nexavar therapy, according to a recently published study.

Richard S. Finn, MD, from the David Geffen School of Medicine at the University of California Los Angeles, and colleagues conducted a retrospective analysis of the RESOURCE trial — the results of which showed Stivarga (regorafenib, Bayer) significantly improved overall survival in patients whose HCC progressed during Nexavar (sorafenib, Bayer) therapy — to verify the outcomes of sequential treatment with sorafenib followed by regorafenib. Read more

Abstinence does not reduce HCC risk in alcoholic-related cirrhosis

Alcohol abstinence did not reduce the risk for hepatocellular carcinoma among patients with Child-Pugh class A or B alcohol-related cirrhosis, according to a presentation at the International Liver Congress 2018.

“Our goal was to investigate if abstinence reduces HCC risk in a series of patients with alcoholic liver cirrhosis who were included in an HCC surveillance program,” Andrés Castano-Garcia, MD, PhD, from the Hospital Universitario Central de Asturias in Spain, said in his presentation. “Abstinence was defined as the absence of any alcohol consumption from inclusion and established based on interviews with patients.” Read more

Novel score predicts liver cancer risk during HBV antiviral therapy

Researchers developed a predictive risk score for the development hepatocellular carcinoma during oral antiviral therapy in patients with chronic hepatitis B, according to recently published data.

“The score requires simple information that is readily available in all treated patients,” Yao-Chun Hsu, MD, from the Fu-Jen Catholic University, Taiwan, and colleagues wrote. “By stratifying patients at different risks of HCC, the easily applicable score may inform the clinical practice and healthcare policy in the era of antiviral treatment for [chronic HBV].” Read more