International Liver Congress

International Liver Congress

Source:

Poynard T, et al. Abstract GS-1065. Presented at: The International Liver Congress; June 23-26 (virtual meeting).

Disclosures: Poynard reports inventing the FibroTest, LCR1 and LCR2 as well as founding BioPredictive. Please see the study for all other authors’ relevant financial disclosures.
June 29, 2021
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Liver cancer test algorithm identifies risk for HCC in hepatitis C

Source:

Poynard T, et al. Abstract GS-1065. Presented at: The International Liver Congress; June 23-26 (virtual meeting).

Disclosures: Poynard reports inventing the FibroTest, LCR1 and LCR2 as well as founding BioPredictive. Please see the study for all other authors’ relevant financial disclosures.
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Researchers validated a liver cancer risk test algorithm for identifying patients with chronic hepatitis C at low risk for hepatocellular carcinoma, according to a study presented at The Digital International Liver Congress.

“HCC is the fourth leading cause of cancer-related death worldwide; according to the fibrosis stage, guidelines for surveillance varied,” Thierry Poynard, MD, PhD, Sorbonne Universite, said. “We constructed and internally validated in 2018 the Liver Cancer Risk test algorithm (LCR1-LCR2), which was the original study, in chronic liver diseases. This multi-analyte blood test combines proteins involved in liver cell repair, known HCC risk factors, specific markers of fibrosis and alpha-fetoprotein.”

In a retrospective review, researchers analyzed 4,903 patients with chronic HCV (median age 53 years; 49% men) from a previous study cohort to externally validate the negative predictive value (NPV) of LCR1-LCR2 at 5 years for the occurrence of HCC and survival without HCC. They used an additional post-hoc analysis to compare the NPV of LCR1-LCR2 vs. the NPV of AASLD standard surveillance. Researchers noted 77% (n = 3,755) of patients were LCR1-LCR2 low-risk and 23% (n = 1,148) of patients were LCR1-LCR2 high-risk.

During a median of 5.7 years, 77.3% of patients had a sustained virological response; incidence of HCC occurred in 137 patients at 5 years and 214 patients at the end of follow-up. When stratified by risk group, HCC occurred at 5 years in 24 low-risk patients vs. 113 high-risk patients. Overall NVPs for LCR1-LCR2 vs. AASLD standard surveillance were 99.4% (95% CI, 99.1-99.6) vs. 97.8% (95% CI, 97.6-98), respectively. The LCR1-LCR2 algorithm yielded a HR of 10.79 (95% CI, 8.14-14.31) in multivariate analysis.

“This external cohort of patients with chronic HCV validates the performance of LCR1-LCR2 to assess the risk for HCC at 5-years. The NPV was 99.4%, which is similar to the 99.5% (95% CI, 99-99.7) previously observed in the original study,” Poynard concluded. “This algorithm could help clinicians reassure 76% of patients with chronic HCV with low-risk LCR1-LCR2 scores and discuss surveillance in those with high-risk LCR1-LCR2 scores.”