Palliative Care for People With Hepatocellular Carcinoma, and Specific Benefits for Older Adults

Woodrell, Christopher D.; Hansen, Lissi; Schiano, Thomas D.; Goldstein, Nathan E.

doi:10.1016/j.clinthera.2018.02.017

Cited by 43 publications

(32 citation statements)

References 93 publications

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“…Although liver cancer can be classified into several different types, HCC is the most common type of primary liver cancer in adults 9 . HCC is related to chronic viral hepatitis infection (including hepatitis B and C) and toxic exposure (e.g., aflatoxin B1) 10 .…”

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confidence: 99%

Efficacy of anti-CD147 chimeric antigen receptors targeting hepatocellular carcinoma

et al. 2020

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Chimeric antigen receptor (CAR) therapy is a promising immunotherapeutic strategy for treating multiple refractory blood cancers, but further advances are required for solid tumor CAR therapy. One challenge is identifying a safe and effective tumor antigen. Here, we devise a strategy for targeting hepatocellular carcinoma (HCC, one of the deadliest malignancies). We report that T and NK cells transduced with a CAR that recognizes the surface marker, CD147, also known as Basigin, can effectively kill various malignant HCC cell lines in vitro, and HCC tumors in xenograft and patient-derived xenograft mouse models. To minimize any on-target/off-tumor toxicity, we use logic-gated (log) GPC3–synNotch-inducible CD147-CAR to target HCC. LogCD147-CAR selectively kills dual antigen (GPC3+CD147+), but not single antigen (GPC3-CD147+) positive HCC cells and does not cause severe on-target/off-tumor toxicity in a human CD147 transgenic mouse model. In conclusion, these findings support the therapeutic potential of CD147-CAR-modified immune cells for HCC patients.

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confidence: 99%

Efficacy of anti-CD147 chimeric antigen receptors targeting hepatocellular carcinoma

et al. 2020

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“…[16] More importantly, the use of hospice care provided the opportunity for patients to die outside the hospital environment which has been shown to be the preference for patients dying with cancer. [21] In addition to improvement in survival and lower rates of in-hospital death, we found the use of hospice care to provide lower charges. In fact, those in hospice care had daily charges that were about 49% lower than those who were not receiving hospice care.…”

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confidence: 74%

Hospice care utilisation among elderly patients who died with hepatocellular carcinoma in the United States

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Indeed, patient requirements will differ as their disease progresses, transitioning from early discussions of advanced care planning, engagement, and provision of support for family members or carers, management of symptoms, end of life care, and finally bereavement management for family and carers (Table 2). Unfortunately, there are few data to guide how best to implement or integrate the services that palliative care can offer throughout the course of HCC, particularly during the early stages of disease when palliative care is most frequently neglected 31 . Quality indicators for palliative care in the United States include that all patients with BCLC stage D HCC or end‐stage liver disease (ESLD) should be offered palliative care, with or without inpatient hospice treatment; however, there is no mention of earlier disease stages 32 .…”

Section: Role Of Palliative Care In Hepatocellular Carcinomamentioning

confidence: 99%

Palliative care in hepatocellular carcinoma

Laube

Sabih

Strasser

et al. 2020

J of Gastro and Hepatol

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Hepatocellular carcinoma is a common cancer with a poor prognosis, associated with high economic costs and a significant burden of disease. While it is often asymptomatic in the early stages, patients may experience great discomfort from advanced disease, treatment adverse effects, or decompensation of underlying cirrhosis. Palliative care has the potential to markedly improve quality of life, physical, and psychological symptoms in patients with end‐stage liver disease, and has been shown to prolong survival in some nonhepatocellular carcinoma malignancies. However, this service is underutilized in hepatocellular carcinoma, and referrals are frequently late due to factors such as stigmatization, inadequate resources, lack of education for nonpalliative care physicians and inadequate modeling for integration of palliative and supportive care within liver disease services. In the future, education workshops, population‐based awareness campaigns, increased funding and improved models of care, may improve the uptake of palliative care and subsequently optimize patient care, particularly towards the end of life.

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Palliative Care for People With Hepatocellular Carcinoma, and Specific Benefits for Older Adults

Abstract: Integrating palliative care into the treatment of patients with HCC has the potential to improve outcomes, although more research is needed to build this evidence base.

Cited by 43 publications

References 93 publications

Efficacy of anti-CD147 chimeric antigen receptors targeting hepatocellular carcinoma

Efficacy of anti-CD147 chimeric antigen receptors targeting hepatocellular carcinoma

Hospice care utilisation among elderly patients who died with hepatocellular carcinoma in the United States

Palliative care in hepatocellular carcinoma

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