Hepatic OncologyPub Date : 2025-12-01Epub Date: 2025-04-22DOI: 10.1080/20450923.2025.2493457
Miho Akabane, Yuki Imaoka, Jun Kawashima, Timothy M Pawlik
{"title":"Advancing precision medicine in hepatocellular carcinoma: current challenges and future directions in liquid biopsy, immune microenvironment, single nucleotide polymorphisms, and conversion therapy.","authors":"Miho Akabane, Yuki Imaoka, Jun Kawashima, Timothy M Pawlik","doi":"10.1080/20450923.2025.2493457","DOIUrl":"https://doi.org/10.1080/20450923.2025.2493457","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) remains a health concern characterized by heterogeneity and high mortality. Surgical resection, radiofrequency ablation, trans-arterial chemoembolization, and liver transplantation offer potentially curative treatments for early-stage disease, but recurrence remains high. Most patients present with advanced-stage HCC, where locoregional therapies are less effective, and systemic treatments-primarily multi-kinase inhibitors and immune checkpoint inhibitors-often yield limited responses. Precision medicine aims to tailor therapy to molecular and genetic profiles, yet its adoption in HCC is hindered by inter-/intra-tumoral heterogeneity and limited biopsy availability. Advances in molecular diagnostics support reintroducing tissue sampling to better characterize genetic, epigenetic, and immunological features. Liquid biopsy offers a minimally invasive method for capturing real-time tumor evolution, overcoming spatial and temporal heterogeneity. Artificial intelligence and machine learning are revolutionizing biomarker discovery, risk stratification, and treatment planning by integrating multi-omics data. Immunological factors such as tumor-infiltrating lymphocytes, natural killer cells, macrophages, and fibroblasts have emerged as determinants of HCC progression and treatment response. Conversion therapy-combining systemic agents with locoregional treatments-has showndemonstrated promise in downstaging unresectable HCC. Ongoing efforts to refine biomarker-driven approaches and optimize multi-modality regimens underscore precision medicine's potential to improve outcomes. PubMed (January 2002-February 2025) was searched for relevant studies.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"12 1","pages":"2493457"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2025-12-01Epub Date: 2025-04-30DOI: 10.1080/20450923.2025.2494446
Fouad Jaber, Hashem B El-Serag
{"title":"HES V2.0 surpasses GALAD for HCC detection: a review of multi-dimensional biomarker scores and studies.","authors":"Fouad Jaber, Hashem B El-Serag","doi":"10.1080/20450923.2025.2494446","DOIUrl":"https://doi.org/10.1080/20450923.2025.2494446","url":null,"abstract":"<p><p>This was a narrative review of select studies published through September of 2024. We review the shift toward multi-dimensional scores such as HCC early detection screening (HES), GALAD, ASAP, and mt-HBT represents a significant advancement in biomarker research for hepatocellular carcinoma (HCC) detection. Unlike single biomarker approaches, these scores integrate various clinical and biochemical factors to enhance predictive accuracy by reflecting different complementary aspects of disease progression and HCC oncogenesis. Proper testing and validation of biomarker scores in phase 3 biomarker studies is essential before wide use can be recommended. We also review the comparative performance of biomarker scores in phase 3 studies. The new version of HES (HES V2.0) which includes AFP, AFP L3, DCP, and changes in their levels the past one year, if available, in addition to age, platelets, albumin, ALT and underlying liver disease etiology outperforms GALAD in detecting early-stage HCC with overall 6.7% higher sensitivity, and ASAP with 13.4%-18.0% higher sensitivity, both at fixed 90% specificity. HES V2.0 is a leading candidate biomarker score for prospective testing in clinical studies of early HCC detection.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"12 1","pages":"2494446"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2024-12-31Epub Date: 2024-10-09DOI: 10.1080/20450923.2024.2403334
Joy A Awosika, Cecilia Monge, Tim F Greten
{"title":"Integration of circulating tumor DNA in biliary tract cancer: the emerging landscape.","authors":"Joy A Awosika, Cecilia Monge, Tim F Greten","doi":"10.1080/20450923.2024.2403334","DOIUrl":"10.1080/20450923.2024.2403334","url":null,"abstract":"<p><p>Precision medicine has emerged as a cornerstone in cancer treatment revolutionizing our approach across malignancies. Molecular profiling of biliary tract cancers (BTCs) has changed the treatment landscape positively by prolonging survival in an aggressively fatal malignancy in its advanced stages. The acquisition of tissue tumor DNA for genomic analysis in BTC is often anatomically challenging, limited by quantity and quality. In response, ctDNA has emerged as a noninvasive means of molecular profiling. The utility of both plasma and bile ctDNA has been explored in several studies demonstrating the high mutation detection rates and the ability to isolate targetable mutations when present. In addition, the concordance between plasma and tissue DNA provides validity in utilizing ctDNA results to infer treatment decisions. Analysis of ctDNA in BTC has also provided prognostic information and facilitated evaluation of clonal evolution with ease of serial measurements. Insight into novel mechanisms of resistance to targeted therapies are being uncovered in ctDNA. As research endeavors continue to deepen our understanding in the field particularly in the space of ctDNA surveillance after curative intent, the tremendous progress made so far has enabled integration of ctDNA into the clinical practice of BTCs.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"11 1","pages":"2403334"},"PeriodicalIF":1.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2024-12-31Epub Date: 2024-09-27DOI: 10.1080/20450923.2024.2403323
Taoyuan M Beninato, Saber A Amin, Michael J Baine, Chi Lin
{"title":"Role of immunotherapy in the overall survival of gastrointestinal cancer patients with liver metastases.","authors":"Taoyuan M Beninato, Saber A Amin, Michael J Baine, Chi Lin","doi":"10.1080/20450923.2024.2403323","DOIUrl":"10.1080/20450923.2024.2403323","url":null,"abstract":"<p><p><b>Aim:</b> To investigate the role of immunotherapy in the overall survival (OS) of gastrointestinal cancer patients who have liver metastases at the time of the primary site cancer diagnosis.<b>Materials & methods:</b> Survival outcome was compared between groups with immunotherapy and groups without immunotherapy.<b>Results:</b> Chemoimmunotherapy was associated with improved OS (hazard ratio [HR] 0.768; 95% CI 0.739-0.800; <i>p</i> < 0.001) compared with chemotherapy alone. Radiotherapy to the primary site plus chemoimmunotherapy was also associated with improved OS (HR 0.796; 95% CI 0.705-0.898; <i>p</i> < 0.001) compared to chemoradiation. Chemoimmunotherapy with radiotherapy to metastatic sites (except liver) was associated with improved OS (HR 0.771; 95% CI 0.706-0.842; <i>p</i> < 0.001) compared to chemoradiation.<b>Conclusion:</b> Immunotherapy plus chemotherapy or chemoradiation was associated with improved OS compared with chemotherapy or chemoradiation without immunotherapy.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"11 1","pages":"2403323"},"PeriodicalIF":1.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2024-12-31Epub Date: 2024-09-12DOI: 10.1080/20450923.2024.2389031
Xiaojing Wang, Keisuke Ishimatsu, Junjie Li, Xiaodong Wen, Weijun Ou, Arnida Anwar, Jaideep Chaudhary, Masaya Takahashi, A Dean Sherry, Ian R Corbin
{"title":"APT imaging of hepatocellular carcinoma signals an effective therapeutic response in advance of tumor shrinkage.","authors":"Xiaojing Wang, Keisuke Ishimatsu, Junjie Li, Xiaodong Wen, Weijun Ou, Arnida Anwar, Jaideep Chaudhary, Masaya Takahashi, A Dean Sherry, Ian R Corbin","doi":"10.1080/20450923.2024.2389031","DOIUrl":"10.1080/20450923.2024.2389031","url":null,"abstract":"<p><p><b>Aim:</b> The aim of this study was to assess the utility of weighted amide proton transfer (APT<sub>w</sub>) MRI in three different rodent models of hepatocellular carcinoma (HCC).<b>Methods:</b> APT<sub>w</sub> MRI was evaluated in models of diethylnitrosamine (DEN) induced HCC, N1S1 syngeneic orthotopic xenograft and human HepG2 ectopic xenograft.<b>Results:</b> All models of HCC showed a higher APT<sub>w</sub> signal over the surrounding normal tissues. In the DEN model, the APT<sub>w</sub> signal could differentiate HCC lesions from benign nodules. Intra-arterial administration of low-density lipoprotein docosahexaenoic acid (LDL-DHA) nanoparticles to N1S1 xenografts rapidly lowered the tumor APT<sub>w</sub> signal within 72 h. Direct injections of LDL-DHA nanoparticles into HepG2 xenografts also showed similar therapeutic responses.<b>Conclusion:</b> We have demonstrated the utility of APT<sub>w</sub> imaging in the diagnostic/therapeutic management of HCC.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"11 1","pages":"2389031"},"PeriodicalIF":1.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2024-12-31Epub Date: 2024-10-07DOI: 10.1080/20450923.2024.2403331
Young Mi Hong
{"title":"Comparison of long-term clinical outcomes between radiofrequency ablation and hepatic resection in patients with small (≤2 cm) hepatocellular carcinoma.","authors":"Young Mi Hong","doi":"10.1080/20450923.2024.2403331","DOIUrl":"10.1080/20450923.2024.2403331","url":null,"abstract":"<p><p><b>Aim:</b> The present study aimed to compare the long-term survival outcomes of hepatic resection (HR) and radiofrequency ablation (RFA) in patients with single small (≤2 cm) hepatocellular carcinoma (HCC).<b>Materials & methods:</b> This retrospective study enrolled patients with a single small HCC measuring 2 cm or smaller underwent HR or RFA as their initial treatment.<b>Results:</b> Overall survival (OS) was significantly higher in the HR group than in the RFA group, while no significant difference was observed in recurrence free survival (RFS) between the two groups. However, after propensity score matching, both OS and RFS in the HR group were significantly higher than in the RFA group. Multivariate analysis showed that patients with hepatitis B virus infection, elevated prothrombin-induced by vitamin K absence or antagonist-II, and albumin-bilirubin (ALBI) grade 2/3 before treatment had poorer OS. Patients with ALBI grade 1 in the HR group demonstrated the highest OS.<b>Conclusion:</b> HR showed significantly better long-term OS and RFS compared with RFA in patients with as a single HCC (≤2 cm). Moreover, the ALBI grade may help identify patients who would benefit from HR or RFA.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"11 1","pages":"2403331"},"PeriodicalIF":1.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2024-03-14eCollection Date: 2023-12-01DOI: 10.2217/hep-2023-0004
Soo Jin Seung, Hasnain Saherawala, Brandon Zagorski, Carman Tong, Howard Lim, Peter Kim, Vladimir Marquez, Sharlene Gill, David Liu, Janine M Davies
{"title":"Treatment journey of patients with hepatocellular carcinoma using real-world data in British Columbia, Canada.","authors":"Soo Jin Seung, Hasnain Saherawala, Brandon Zagorski, Carman Tong, Howard Lim, Peter Kim, Vladimir Marquez, Sharlene Gill, David Liu, Janine M Davies","doi":"10.2217/hep-2023-0004","DOIUrl":"10.2217/hep-2023-0004","url":null,"abstract":"<p><strong>Aim: </strong>This study examined treatment patterns, survival outcomes and healthcare costs related to hepatocellular carcinoma (HCC) in British Columbia.</p><p><strong>Methods: </strong>The study utilized data from two physician databases (HCC and MOTION) and the provincial British Columbia transplant database.</p><p><strong>Results: </strong>The analysis revealed diverse treatment approaches and identified the varying treatment journeys of patients. Liver transplant and systemic therapies demonstrated improved survival rates. However, there was a scarcity of Canadian-specific cost data.</p><p><strong>Conclusion: </strong>The research emphasizes the complexities of managing HCC and underscores the need for personalized treatment strategies to enhance patient outcomes. These findings contribute valuable insights into HCC management and provide a foundation for future studies and interventions aimed at optimizing care and resource allocation.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"10 4","pages":"HEP50"},"PeriodicalIF":5.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2023-10-12eCollection Date: 2023-09-01DOI: 10.2217/hep-2023-0003
Alexandra V Kimchy, Harjit Singh, Esha Parikh, Jessica Rosenberg, Kavya Sanghavi, James H Lewis
{"title":"The predictive value of liver tests for the presence of liver metastases.","authors":"Alexandra V Kimchy, Harjit Singh, Esha Parikh, Jessica Rosenberg, Kavya Sanghavi, James H Lewis","doi":"10.2217/hep-2023-0003","DOIUrl":"10.2217/hep-2023-0003","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the predictive value of biochemical liver tests in patients with malignant melanoma, breast, colorectal or lung cancers at the time of diagnosis of liver metastases.</p><p><strong>Methods: </strong>A retrospective review of patients with the above-mentioned solid tumors at MedStar Georgetown University Hospital from 2016-2020.</p><p><strong>Results: </strong>The highest optimal cutoff according to sensitivity and specificity for the presence of liver metastases was for AST ≥1.5 × ULN for melanoma, lung, and breast cancers and ≥2 × ULN for colorectal cancer, ALT ≥1.25 × ULN for melanoma, breast and colorectal cancers and ≥1.5 × ULN for lung cancer, and ALP ≥1.5 × ULN for melanoma, breast and colorectal cancers.</p><p><strong>Conclusion: </strong>Using thresholds of liver enzymes above the ULN may improve the diagnostic accuracy for the presence of liver metastases.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"10 3","pages":"HEP48"},"PeriodicalIF":5.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10599222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hepatic arterial infusion chemotherapy with or without lenvatinib for unresectable cholangiocarcinoma: a single-center retrospective study.","authors":"Yajing Wang, Zhanqi Wei, Zheng Zhang, Jingyi Xu, Yaqin Wang, Qian Chen, Yuewei Zhang","doi":"10.2217/hep-2023-0006","DOIUrl":"10.2217/hep-2023-0006","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this study is to compare the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) of oxaliplatin, fluorouracil and leucovorin (FOLFOX) plus lenvatinib and FOLFOX-HAIC alone in patients with unresectable cholangiocarcinoma.</p><p><strong>Patients & methods: </strong>Retrospective analysis of patients receiving FOLFOX-HAIC with or without lenvatinib.</p><p><strong>Results: </strong>Forty-one patients were included, with 22 patients receiving HAIC alone and 19 patients receiving HAIC plus lenvatinib. Combination treatment significantly prolonged overall survival and progression-free survival compared with HAIC alone. Grade 1-2 adverse events were more frequent in the combination group but manageable. No severe AEs or treatment-related deaths were reported.</p><p><strong>Conclusion: </strong>FOLFOX-HAIC plus lenvatinib has the potential to be a treatment option for unresectable cholangiocarcinoma.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"10 2","pages":"HEP49"},"PeriodicalIF":5.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/57/hep-10-49.PMC10577516.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hepatic OncologyPub Date : 2023-08-09eCollection Date: 2023-03-01DOI: 10.2217/hep-2023-0002
Abdalla Aly, Nicole Fulcher, Brian Seal, Trang Pham, Yunfei Wang, Scott Paulson, Aiwu R He
{"title":"Clinical outcomes by Child-Pugh Class in patients with advanced hepatocellular carcinoma in a community oncology setting.","authors":"Abdalla Aly, Nicole Fulcher, Brian Seal, Trang Pham, Yunfei Wang, Scott Paulson, Aiwu R He","doi":"10.2217/hep-2023-0002","DOIUrl":"10.2217/hep-2023-0002","url":null,"abstract":"<p><strong>Aim: </strong>Many pivotal trials in advanced hepatocellular carcinoma (HCC) require participants to have Child-Pugh A disease. However, many patients in real-world practice are Child-Pugh B or C. This study examined treatment patterns and clinical outcomes in patients with advanced HCC treated with first-line systemic therapy.</p><p><strong>Materials & methods: </strong>In this retrospective study, patients with HCC treated with first-line systemic therapy (2010-2017) were identified from US Oncology Network records. Outcomes included overall survival and progression-free survival, by Child-Pugh Class and prior liver-directed therapy.</p><p><strong>Results: </strong>Of 352 patients, 78.7% were Child-Pugh A or B, 96.6% received first-line sorafenib, and 33.8% received first-line-prior liver-directed therapy. Survival outcomes were similar for Child-Pugh A or B, and longer after first-line prior liver-directed therapy.</p><p><strong>Conclusion: </strong>First-line systemic therapy is beneficial in patients with Child-Pugh A or B, and after first-line prior liver-directed therapy. These findings may help position systemic therapy in the community setting.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"10 1","pages":"HEP47"},"PeriodicalIF":1.2,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/7c/hep-10-47.PMC10413176.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10352609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}