Pub Date : 2016-01-01Epub Date: 2015-11-30DOI: 10.2217/hep.15.35
Morris Sherman
Patients with liver disease have a risk of developing hepatocellular carcinoma (HCC), but the risk varies between different diseases and is also different according to several other variables, such as age, type of underlying liver disease and severity of disease. Several risk scores have been developed to more adequately quantitate HCC risk in individual patients. Each risk score is applicable to a specific population (chronic hepatitis B or C, patients on the transplant list, cirrhosis in general, and so on). Most publications on risk scores do not provide clear guidance as to what level of measured risk is sufficient to trigger surveillance.
{"title":"Liver cancer screening in high-risk populations.","authors":"Morris Sherman","doi":"10.2217/hep.15.35","DOIUrl":"https://doi.org/10.2217/hep.15.35","url":null,"abstract":"<p><p>Patients with liver disease have a risk of developing hepatocellular carcinoma (HCC), but the risk varies between different diseases and is also different according to several other variables, such as age, type of underlying liver disease and severity of disease. Several risk scores have been developed to more adequately quantitate HCC risk in individual patients. Each risk score is applicable to a specific population (chronic hepatitis B or C, patients on the transplant list, cirrhosis in general, and so on). Most publications on risk scores do not provide clear guidance as to what level of measured risk is sufficient to trigger surveillance.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"3 1","pages":"13-18"},"PeriodicalIF":5.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep.15.35","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471147","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}
Pub Date : 2016-01-01Epub Date: 2015-11-30DOI: 10.2217/hep.15.40
Iain H McKillop, Laura W Schrum, Kyle J Thompson
Hepatocellular carcinoma (HCC) is a significant cause of cancer-related morbidity and mortality. Chronic, heavy ethanol consumption is a major risk for developing the worsening liver pathologies that culminate in hepatic cirrhosis, the leading risk factor for developing HCC. A significant body of work reports the biochemical and pathological consequences of ethanol consumption and metabolism during hepatocarcinogeneis. The systemic effects of ethanol means organ system interactions are equally important in understanding the initiation and progression of HCC within the alcoholic liver. This review aims to summarize the effects of ethanol-ethanol metabolism during the pathogenesis of alcoholic liver disease, the progression toward HCC and the importance of ethanol as a comorbid factor for HCC development.
{"title":"Role of alcohol in the development and progression of hepatocellular carcinoma.","authors":"Iain H McKillop, Laura W Schrum, Kyle J Thompson","doi":"10.2217/hep.15.40","DOIUrl":"10.2217/hep.15.40","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a significant cause of cancer-related morbidity and mortality. Chronic, heavy ethanol consumption is a major risk for developing the worsening liver pathologies that culminate in hepatic cirrhosis, the leading risk factor for developing HCC. A significant body of work reports the biochemical and pathological consequences of ethanol consumption and metabolism during hepatocarcinogeneis. The systemic effects of ethanol means organ system interactions are equally important in understanding the initiation and progression of HCC within the alcoholic liver. This review aims to summarize the effects of ethanol-ethanol metabolism during the pathogenesis of alcoholic liver disease, the progression toward HCC and the importance of ethanol as a comorbid factor for HCC development.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"3 1","pages":"29-43"},"PeriodicalIF":5.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep.15.40","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471081","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}
Pub Date : 2016-01-01Epub Date: 2015-11-30DOI: 10.2217/hep.15.43
Marco Imperatori, Loretta D'Onofrio, Eleonora Marrucci, Francesco Pantano, Alice Zoccoli, Giuseppe Tonini
Gall bladder cancer (GBC), and intrahepatic and extrahepatic (perihilar or distal bile duct's) cholangiocarcinomas (CCA) are usually diagnosed in locally advanced or node-positive stage, with a short survival rate. Thus, it appears essential to explore novel strategies for improving disease downstage and radical surgery. Chemoradiotherapy followed by liver transplantation seems to be one of the most promising approaches for intrahepatic or perihilar disease while chemotherapy with novel radiotherapy techniques (such stereotactic body radiation) emerged as an attractive preoperative treatment in distal diseases. In this paper, we will review currently available knowledge about neoadjuvant treatment of biliary tract cancers (BTC) paying attention to challenges that make this type of management in clinical practice difficult.
{"title":"Neoadjuvant treatment of biliary tract cancer: state-of-the-art and new perspectives.","authors":"Marco Imperatori, Loretta D'Onofrio, Eleonora Marrucci, Francesco Pantano, Alice Zoccoli, Giuseppe Tonini","doi":"10.2217/hep.15.43","DOIUrl":"https://doi.org/10.2217/hep.15.43","url":null,"abstract":"<p><p>Gall bladder cancer (GBC), and intrahepatic and extrahepatic (perihilar or distal bile duct's) cholangiocarcinomas (CCA) are usually diagnosed in locally advanced or node-positive stage, with a short survival rate. Thus, it appears essential to explore novel strategies for improving disease downstage and radical surgery. Chemoradiotherapy followed by liver transplantation seems to be one of the most promising approaches for intrahepatic or perihilar disease while chemotherapy with novel radiotherapy techniques (such stereotactic body radiation) emerged as an attractive preoperative treatment in distal diseases. In this paper, we will review currently available knowledge about neoadjuvant treatment of biliary tract cancers (BTC) paying attention to challenges that make this type of management in clinical practice difficult.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"3 1","pages":"93-99"},"PeriodicalIF":5.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep.15.43","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471084","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}
Hepatocellular carcinoma (HCC) is one of the most prevalent cancers and the third leading cause of cancer-related deaths worldwide. In patients with unresectable disease, loco-regional catheter-based intra-arterial therapies (IAT) can achieve selective tumor control while minimizing systemic toxicity. As molecular features of tumor growth and microenvironment are better understood, new targets arise for selective anticancer therapy. Particularly, antiglycolytic drugs that exploit the hyperglycolytic cancer cell metabolism - also known as the 'Warburg effect' - have emerged as promising therapeutic options. Thus, future developments will combine the selective character of loco-regional drug delivery platforms with highly specific molecular targeted antiglycolytic agents. This review will exemplify literature on antiglycolytic approaches and particularly focus on intra-arterial delivery methods.
{"title":"Targeting glucose metabolism in cancer: new class of agents for loco-regional and systemic therapy of liver cancer and beyond?","authors":"L. Savic, J. Chapiro, G. Duwe, J. Geschwind","doi":"10.2217/HEP.15.36","DOIUrl":"https://doi.org/10.2217/HEP.15.36","url":null,"abstract":"Hepatocellular carcinoma (HCC) is one of the most prevalent cancers and the third leading cause of cancer-related deaths worldwide. In patients with unresectable disease, loco-regional catheter-based intra-arterial therapies (IAT) can achieve selective tumor control while minimizing systemic toxicity. As molecular features of tumor growth and microenvironment are better understood, new targets arise for selective anticancer therapy. Particularly, antiglycolytic drugs that exploit the hyperglycolytic cancer cell metabolism - also known as the 'Warburg effect' - have emerged as promising therapeutic options. Thus, future developments will combine the selective character of loco-regional drug delivery platforms with highly specific molecular targeted antiglycolytic agents. This review will exemplify literature on antiglycolytic approaches and particularly focus on intra-arterial delivery methods.","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"3 1 1","pages":"19-28"},"PeriodicalIF":5.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/HEP.15.36","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68215347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01Epub Date: 2015-11-30DOI: 10.2217/hep.15.42
Shukui Qin, Xinlei Gong
Hepatocellular carcinoma (HCC) characterized by insidious onset is a highly invasive malignance and has a rapid progress. The majority of patients, especially in Asian countries, present with locally advanced or distant metastatic disease at diagnosis and are not eligible for local treatment. Before the publication of the EACH study results showing the survival benefits of the FOLFOX 4 regimen in Chinese patients with advanced HCC, no chemotherapeutical drug or regimen was considered as systemic chemotherapy standard for this group of patients due to the lack of evidence-based recommendations. Oxaliplatin-containing regimens have shown clinical activity against advanced HCC with an acceptable safety profile. The aim of this article is to present a review of the scientific evidence mainly originating from China that supports the recommendation of oxaliplatin-based regimens for the treatment of Chinese patients with advanced HCC.
{"title":"Progression of systemic chemotherapy with oxaliplatin-containing regimens for advanced hepatocellular carcinoma in China.","authors":"Shukui Qin, Xinlei Gong","doi":"10.2217/hep.15.42","DOIUrl":"https://doi.org/10.2217/hep.15.42","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) characterized by insidious onset is a highly invasive malignance and has a rapid progress. The majority of patients, especially in Asian countries, present with locally advanced or distant metastatic disease at diagnosis and are not eligible for local treatment. Before the publication of the EACH study results showing the survival benefits of the FOLFOX 4 regimen in Chinese patients with advanced HCC, no chemotherapeutical drug or regimen was considered as systemic chemotherapy standard for this group of patients due to the lack of evidence-based recommendations. Oxaliplatin-containing regimens have shown clinical activity against advanced HCC with an acceptable safety profile. The aim of this article is to present a review of the scientific evidence mainly originating from China that supports the recommendation of oxaliplatin-based regimens for the treatment of Chinese patients with advanced HCC.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"3 1","pages":"71-81"},"PeriodicalIF":5.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep.15.42","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471083","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}
Pub Date : 2016-01-01Epub Date: 2015-11-30DOI: 10.2217/hep.15.37
Augusto Villanueva
Liver cancer is now ranked second in terms of cancer-related mortality worldwide; with limited treatment options for patients at advanced stages it remains a growing health problem. All Phase III clinical trials testing molecular therapies after sorafenib have so far failed, and there is still not a validated oncogene addiction loop. Despite the present huge challenges, advancements in the recent years have been remarkable. The Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE) was designed to promote scientific exchanges of international and regional experts in the study and management of liver cancer. Over the years it has consolidated as a major resource to provide a thorough update to clinicians and researchers located in the Asia-Pacific region in different aspects of liver cancer. Attendance at these meetings is exceptional, with an average of 1000 attendees at each conference. As predicted, the 2015 edition provided an outstanding overview of the latest developments in the clinical management and molecular pathogenesis of the disease.
{"title":"Selected summary for the 2015 Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE).","authors":"Augusto Villanueva","doi":"10.2217/hep.15.37","DOIUrl":"https://doi.org/10.2217/hep.15.37","url":null,"abstract":"<p><p>Liver cancer is now ranked second in terms of cancer-related mortality worldwide; with limited treatment options for patients at advanced stages it remains a growing health problem. All Phase III clinical trials testing molecular therapies after sorafenib have so far failed, and there is still not a validated oncogene addiction loop. Despite the present huge challenges, advancements in the recent years have been remarkable. The Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE) was designed to promote scientific exchanges of international and regional experts in the study and management of liver cancer. Over the years it has consolidated as a major resource to provide a thorough update to clinicians and researchers located in the Asia-Pacific region in different aspects of liver cancer. Attendance at these meetings is exceptional, with an average of 1000 attendees at each conference. As predicted, the 2015 edition provided an outstanding overview of the latest developments in the clinical management and molecular pathogenesis of the disease.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"3 1","pages":"5-8"},"PeriodicalIF":5.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep.15.37","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471144","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}
Hepatocellular carcinoma, one of the most common solid tumors worldwide, is poorly responsive to available chemotherapeutic approaches. While systemic chemotherapy is of limited benefit, intra-arterial delivery of doxorubicin to the tumor frequently produces tumor shrinkage. Its utility is limited, in part, by the frequent emergence of doxorubicin resistance. The mechanisms of this resistance include increased expression of multidrug resistance efflux pumps, alterations of the drug target, topoisomerase, and modulation of programmed cell death pathways. Many of these effects result from changes in miRNA expression and are particularly prominent in tumor cells with a stem cell phenotype. This review will summarize the current knowledge on the mechanisms of doxorubicin resistance of hepatocellular carcinoma and the potential for approaches toward therapeutic chemosensitization.
{"title":"Mechanisms of doxorubicin resistance in hepatocellular carcinoma.","authors":"Josiah Cox, S. Weinman","doi":"10.2217/HEP.15.41","DOIUrl":"https://doi.org/10.2217/HEP.15.41","url":null,"abstract":"Hepatocellular carcinoma, one of the most common solid tumors worldwide, is poorly responsive to available chemotherapeutic approaches. While systemic chemotherapy is of limited benefit, intra-arterial delivery of doxorubicin to the tumor frequently produces tumor shrinkage. Its utility is limited, in part, by the frequent emergence of doxorubicin resistance. The mechanisms of this resistance include increased expression of multidrug resistance efflux pumps, alterations of the drug target, topoisomerase, and modulation of programmed cell death pathways. Many of these effects result from changes in miRNA expression and are particularly prominent in tumor cells with a stem cell phenotype. This review will summarize the current knowledge on the mechanisms of doxorubicin resistance of hepatocellular carcinoma and the potential for approaches toward therapeutic chemosensitization.","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"3 1 1","pages":"57-59"},"PeriodicalIF":5.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/HEP.15.41","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68215380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Chegai, A. Orlacchio, S. Merolla, S. Monti, L. Mannelli
According to Barcelona Clinic Liver Cancer, the recommended first-line treatment for patients with intermediate stage of hepatocellular carcinoma (HCC) is transarterial chemoembolization. Patients with intermediate stage of HCC represent 20% with a 2-year survival of approximately 50%. Nowadays, transarterial therapies have proved precious in the treatment of hepatic malignancies. During the last years, there were important developments in practiced transarterial therapies and their efficacy is still controversial. The purpose of this review is to discuss in further details these transarterial therapies that have been used to treat cases of HCC.
{"title":"Intermediate hepatocellular carcinoma: the role of transarterial therapy.","authors":"F. Chegai, A. Orlacchio, S. Merolla, S. Monti, L. Mannelli","doi":"10.2217/HEP.15.32","DOIUrl":"https://doi.org/10.2217/HEP.15.32","url":null,"abstract":"According to Barcelona Clinic Liver Cancer, the recommended first-line treatment for patients with intermediate stage of hepatocellular carcinoma (HCC) is transarterial chemoembolization. Patients with intermediate stage of HCC represent 20% with a 2-year survival of approximately 50%. Nowadays, transarterial therapies have proved precious in the treatment of hepatic malignancies. During the last years, there were important developments in practiced transarterial therapies and their efficacy is still controversial. The purpose of this review is to discuss in further details these transarterial therapies that have been used to treat cases of HCC.","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"10 1","pages":"399-408"},"PeriodicalIF":5.0,"publicationDate":"2015-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/HEP.15.32","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68215329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-10-01Epub Date: 2015-11-06DOI: 10.2217/hep.15.21
Maurizio Pompili, Giampiero Francica
{"title":"Role of ablation: should it be used as primary therapy for early-stage hepatocellular carcinoma?","authors":"Maurizio Pompili, Giampiero Francica","doi":"10.2217/hep.15.21","DOIUrl":"https://doi.org/10.2217/hep.15.21","url":null,"abstract":"","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"2 4","pages":"339-342"},"PeriodicalIF":5.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep.15.21","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471138","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}
Pub Date : 2015-10-01Epub Date: 2015-11-06DOI: 10.2217/hep.15.22
Jeroen Dekervel, Jos van Pelt, Chris Verslype
Department of Hepatology, University Hospitals Leuven & Department of Clinical & Experimental Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium *Author for correspondence: jeroen.dekervel@med.kuleuven.be Epigenetics are heritable changes in gene expression that occur without changes in DNA sequence [1]. In this editorial we will focus on DNA methylation, the most studied form of epigenetic regulation in cancers of the liver. DNA methylation usually takes place at 5 position of the cytosine ring (resulting in 5mC) within CpG dinucleotides. These dinucleotides are relatively rare and unequally distributed throughout the genome. For example, 60% of human genes have a cluster of CpGs or so called ‘CpG island (CGI)’ in their regulatory region [2]. Methylation of a CGI results in transcriptional silencing of the associated gene. Other genomic regions with high CpG density include repetitive genomic sequences such as centromeres where DNA methylation guards chromosome stability. In a differentiated human cell, CpG islands are mostly unmethylated facilitating expression of the associated gene, whereas the baseline methylation of repetitive sequences prevents mitotic recombinations such as deletions or translocations [3]. DNA methylation, a process catalyzed by DNA methyltransferases, occurs nearly always symmetrical in both the top and bottom strands [4]. This enables propagation of methylation across cell divisions conform the heritable nature of epigenetics as stated in the definition. More recently, it has become clear that DNA undergoes active demethylation as well, regulated by the ten-eleven translocation (TET) family of proteins. These enzymes produce an intermediate, 5-hydroxymethylcytosine or 5hmC, which ultimately leads to unmethylated cytosine [5].
{"title":"DNA methylation in hepatocellular carcinoma: what is the use?","authors":"Jeroen Dekervel, Jos van Pelt, Chris Verslype","doi":"10.2217/hep.15.22","DOIUrl":"https://doi.org/10.2217/hep.15.22","url":null,"abstract":"Department of Hepatology, University Hospitals Leuven & Department of Clinical & Experimental Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium *Author for correspondence: jeroen.dekervel@med.kuleuven.be Epigenetics are heritable changes in gene expression that occur without changes in DNA sequence [1]. In this editorial we will focus on DNA methylation, the most studied form of epigenetic regulation in cancers of the liver. DNA methylation usually takes place at 5 position of the cytosine ring (resulting in 5mC) within CpG dinucleotides. These dinucleotides are relatively rare and unequally distributed throughout the genome. For example, 60% of human genes have a cluster of CpGs or so called ‘CpG island (CGI)’ in their regulatory region [2]. Methylation of a CGI results in transcriptional silencing of the associated gene. Other genomic regions with high CpG density include repetitive genomic sequences such as centromeres where DNA methylation guards chromosome stability. In a differentiated human cell, CpG islands are mostly unmethylated facilitating expression of the associated gene, whereas the baseline methylation of repetitive sequences prevents mitotic recombinations such as deletions or translocations [3]. DNA methylation, a process catalyzed by DNA methyltransferases, occurs nearly always symmetrical in both the top and bottom strands [4]. This enables propagation of methylation across cell divisions conform the heritable nature of epigenetics as stated in the definition. More recently, it has become clear that DNA undergoes active demethylation as well, regulated by the ten-eleven translocation (TET) family of proteins. These enzymes produce an intermediate, 5-hydroxymethylcytosine or 5hmC, which ultimately leads to unmethylated cytosine [5].","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"2 4","pages":"321-323"},"PeriodicalIF":5.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep.15.22","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36468089","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}