What to do about hepatocellular carcinoma: Recommendations for health authorities from the International Liver Cancer Association

Allaire, Manon; Bruix, Jordi; Korenjak, Marko; Manes, Sarah; Maravic, Zorana; Reeves, Helen L.; Salem, Riad; Sangro, Bruno; Sherman, Morris

doi:10.1016/j.jhepr.2022.100578

Cited by 20 publications

(29 citation statements)

References 112 publications

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“…(1) Technical advances in detection of fibrosis using non-invasive tests (NITs) such as serum biomarkers and elastography expand opportunities for early detection in regions, especially outside of major centres (20). ( 2) The high cure rates achieved by DAAs in HCV along with vaccination and effective therapies for HBV have decreased the rates of cirrhosis, decompensation, and cancer (6).…”

Section: What Are the Current Opportunities And Barriers To Supportin...mentioning

confidence: 99%

“…(3) More effective surgical, locoregional, and pharmacological interventions offer cure and extended survival in HCC (6,10).…”

Section: What Are the Current Opportunities And Barriers To Supportin...mentioning

confidence: 99%

“…In addition, Canada lacks effective public health measures such as a national strategy and provincial consistency related to broader population-based screening such as age cohort (born 1945-1975) screening or screening in pregnancy for HCV (22). carriers as an evidence-based means of improving survival through early HCC detection (6,10). Unfortunately, HCC screening has been shown to be suboptimal in patients with cirrhosis likely due to a combination of patient, provider, and system issues (23,24).…”

Section: Viral Controlmentioning

confidence: 99%

“…This natural history, coupled with the stigmatization of CLD, results in significant but preventable physical, psychosocial, and financial burden (4). Recently, major international liver associations have published positions on the need for greater action related to CLD and hepatocellular carcinoma (HCC), proposing frameworks for the principal actions required to improve liver health across health systems (5,6). In Canada, there are national strategies to address diabetes, breast cancer, and other diagnoses of significance, but none to address the growing concerns of CLD.…”

Section: Introductionmentioning

confidence: 99%

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Priority actions for elevating liver health in Canada: A call to action

Brahmania

Biondi

Joshi

et al. 2023

Canadian Liver Journal

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Chronic liver disease (CLD) has become a silent epidemic in our country and has resulted in significant physical, psychosocial, and financial burden. Although other international liver associations have published frameworks for the principal actions required to improve liver health across health systems, Canada does not have a strategy to address the growing concerns of CLD. Thus, a multidisciplinary group of care providers involved in CLD management in Canada gathered to review the current burden of disease, gaps in management, and key opportunities for improving the identification and management of people at risk of developing progressive CLD.

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Section: What Are the Current Opportunities And Barriers To Supportin...mentioning

confidence: 99%

“…(3) More effective surgical, locoregional, and pharmacological interventions offer cure and extended survival in HCC (6,10).…”

Section: What Are the Current Opportunities And Barriers To Supportin...mentioning

confidence: 99%

Section: Viral Controlmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Priority actions for elevating liver health in Canada: A call to action

Brahmania

Biondi

Joshi

et al. 2023

Canadian Liver Journal

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“…Hepatocellular carcinoma (HCC) is one of the most common malignant tumors and imparts a heavy disease burden 1 , 2 . To date, the prognosis of HCC has remained poor 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

Radiomics models based on multisequence MRI for predicting PD-1/PD-L1 expression in hepatocellular carcinoma

Gong,

Liu,

Tao

et al. 2023

Sci Rep

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The purpose of this study was to explore the effectiveness of radiomics based on multisequence MRI in predicting the expression of PD-1/PD-L1 in hepatocellular carcinoma (HCC). One hundred and eight patients with HCC who underwent contrast-enhanced MRI 2 weeks before surgical resection were enrolled in this retrospective study. Corresponding paraffin sections were collected for immunohistochemistry to detect the expression of PD-1 and PD-L1. All patients were randomly divided into a training cohort and a validation cohort at a ratio of 7:3. Univariate and multivariate analyses were used to select potential clinical characteristics related to PD-1 and PD-L1 expression. Radiomics features were extracted from the axial fat-suppression T2-weighted imaging (FS-T2WI) images and the arterial phase and portal venous phase images from the axial dynamic contrast-enhanced MRI, and the corresponding feature sets were generated. The least absolute shrinkage and selection operator (LASSO) was used to select the optimal radiomics features for analysis. Logistic regression analysis was performed to construct single-sequence and multisequence radiomics and radiomic-clinical models. The predictive performance was judged by the area under the receiver operating characteristic curve (AUC) in the training and validation cohorts. In the whole cohort, PD-1 expression was positive in 43 patients, and PD-L1 expression was positive in 34 patients. The presence of satellite nodules served as an independent predictor of PD-L1 expression. The AUC values of the FS-T2WI, arterial phase, portal venous phase and multisequence models in predicting the expression of PD-1 were 0.696, 0.843, 0.863, and 0.946 in the training group and 0.669, 0.792, 0.800 and 0.815 in the validation group, respectively. The AUC values of the FS-T2WI, arterial phase, portal venous phase, multisequence and radiomic-clinical models in predicting PD-L1 expression were 0.731, 0.800, 0.800, 0.831 and 0.898 in the training group and 0.621, 0.743, 0.771, 0.810 and 0.779 in the validation group, respectively. The combined models showed better predictive performance. The results of this study suggest that a radiomics model based on multisequence MRI has the potential to predict the preoperative expression of PD-1 and PD-L1 in HCC, which could become an imaging biomarker for immune checkpoint inhibitor (ICI)-based treatment.

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Risk versus Benefit of Tyrosine Kinase Inhibitors for Hepatocellular Carcinoma: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Payo‐Serafín,

Méndez‐Blanco,

Fernández‐Palanca

et al. 2024

Clin Pharma and Therapeutics

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Although the treatment landscape has rapidly evolved over the last years, hepatocellular carcinoma (HCC) is one of the most lethal cancers. With recent advances, both immunotherapy and tyrosine kinase inhibitors (TKIs)‐based chemotherapy constitute the standard treatment for advanced HCC. A systematic search of randomized clinical trials employing TKIs was performed in 17 databases, obtaining 25 studies evaluating the prognosis, tumor response, and presence of adverse events (AEs) related to TKIs in HCC. Overall effect sizes were estimated for the hazard ratios (HR) and odds ratios (OR) with 95% confidence interval (CI), either extracted or calculated with the Parmar method, employing STATA 16. Heterogeneity was assessed by Chi‐square‐based Q‐test and inconsistency (I2) statistic; source of heterogeneity by meta‐regression and subgroup analysis; and publication bias by funnel plot asymmetry and Egger's test. The research protocol was registered in PROSPERO (CRD42023397263). Meta‐analysis revealed a correlation between survival and tumor response parameters and TKI treatment vs. placebo, despite detecting high heterogeneity. Combined TKI treatment showed a significantly better objective response rate (ORR) with no heterogeneity, whereas publication bias was only detected with time to progression (TTP). Few gastrointestinal and neurological disorders were associated with TKI treatment vs. placebo or with combined treatment. However, a higher number of serious AEs were related to TKI treatment vs. sorafenib alone. Results show positive clinical benefits from TKI treatment, supporting the approval and maintenance of TKI‐based therapy for advanced HCC, while establishing appropriate strategies to maximize efficacy and minimize toxicity.

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What to do about hepatocellular carcinoma: Recommendations for health authorities from the International Liver Cancer Association

Cited by 20 publications

References 112 publications

Priority actions for elevating liver health in Canada: A call to action

Priority actions for elevating liver health in Canada: A call to action

Radiomics models based on multisequence MRI for predicting PD-1/PD-L1 expression in hepatocellular carcinoma

Risk versus Benefit of Tyrosine Kinase Inhibitors for Hepatocellular Carcinoma: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

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