Hepatic Oncology最新文献

Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. A careful multidisciplinary assessment of tumor characteristics, liver function and physical status is required for proper therapeutic management. In recent years, several studies have supported the feasibility and benefit of combined therapy in the treatment of single large HCC, defined as those exceeding 3 cm in size. We present a case of combined treatment using radiofrequency ablation followed by trans-arterial chemoembolization with radiopaque embolic beads. The aim of this technical report was to describe the radiologic findings during combined radiofrequency ablation and radiopaque bead embolization, pointing out the differences and the potential advantages of using radiopaque beads compared with non-radiopaque beads. Furthermore, it is also the first report on using radiopaque beads in combined treatment for HCC.

Transarterial chemoembolization (TACE) is the gold standard of therapy for patients with unresectable intermediate stage hepatocellular carcinoma (HCC), and is also commonly used as postresection adjuvant therapy in Asia. The delivery of TACE is highly variable from center to center, and clinical decision making for patients is based primarily on tumor staging guidelines, with very little focus on individualized tumor features. This review will discuss recent efforts for improving patient outcomes with TACE treatment through personalized medicine advances, including ongoing clinical trials investigating the combination of targeted therapy with TACE and the discovery of prognostic biomarkers for predicting TACE response.

Aim: We investigated the behavior of circulating endothelial cells (CEC) in patients with hepatocellular carcinoma (HCC) receiving sorafenib, and whether CEC levels were associated with time to progression (TTP).

Materials & methods: CECs in advanced HCC patients receiving sorafenib were counted at baseline and every 4 weeks.

Results: Twenty four HCC patients were enrolled in the study. Median TTP was 3.2 months (1-6). Median baseline CEC levels were 67 cells/ml, with an increase of 169.8% after 4 weeks of treatment. Any time CEC levels in patients with a TTP lower than 4 months were higher, but not statistically significant, compared with those in patients with TTP more than 4 months.

Conclusion: Treatment with sorafenib changed CEC levels in HCC patients.

Aim: The aim is to report clinical outcomes of hepatic intra-arterial (IACHT) and systemic chemotherapy (SCHT), followed by gemcitabine-based maintenance therapy (maintenance), for the treatment of relapsed or unresectable cholangiocarcinoma.

Patients & methods: In this retrospective observational study, 145 cholangiocarcinoma patients were treated with Epirubicin-Cisplatin as IACHT associated with Capecitabine or 5-fluorouracil as SCHT. Maintenance was performed with gemcitabine-based schedule. Toxicity was assessed with NCI-CTCAE and tumor response with RECIST 1.1.

Results: Tumor response was complete in 1%, partial in 20%, stable disease in 48% and progression in 31% of patients (3 months after therapy). The most frequent adverse events were: anemia (24%), nausea and vomiting (33%), alopecia (60%).

Conclusion: Cholangiocarcinoma patients may benefit from IAHCT-SCHT. Maintenance may prolong clinical benefits. ClinicalTrials.gov registry Identifier: NCT01920503.

Isabel Fabregat speaks to Roshaine Wijayatunga, Managing Commissioning Editor. Isabel Fabregat, PhD, is Senior Investigator, Head of the group "TGF-β and cancer", at the Bellvitge Biomedical Research Institute (IDIBELL) and Associate Professor in the School of Medicine and Health Sciences at the University of Barcelona. She is the President of the Spanish Society for Cell Biology since 2011, she was member of the Executive Board of the Spanish Branch of the European Tissue Culture Society and she is currently member of the Spanish Society for the Study of the Liver, and the International Liver Cancer Association, among others. The current research line of her laboratory focuses on the dissection of the molecular mechanisms induced by TGF-β in liver cells that can explain its different, and sometimes opposite, functions in liver pathologies, in particular fibrosis and hepatocarcinogenesis. Cross-talk between TGF-β and other pathways, in particular EGFR signaling, is also one of the current interests of the lab. From October 2012 she has coordinated an Initial Training Network - Marie Curie European Action that under the acronym of 'IT-LIVER' (Inhibiting TGF-β in Liver Diseases) integrates different European academic groups and small enterprises to develop a multidisciplinary training program for talented young researchers, to prepare them for leading roles in chronic liver disease research. Dr Fabregat has published around 130 articles in indexed journals, as well as several book chapters, with her work published in Hepatology, Journal of Hepatology, Genes & Development, Cancer Research, Oncogene, FASEB Journal, Free Radical in Biology & Medicine, Journal of Cell Science, Journal of Biological Chemistry, among others. She is an editorial member of the World Journal of Gastroenterology, World Journal of Hepatology, Frontiers in Physiology-Gastrointestinal Sciences, Frontiers in Pharmacology, Current Signal Transduction Therapy and Hepatic Oncology.