Liver Cancer

Liver Cancer

The major causes of liver cancer are well understood and preventable, as many cases are caused by hepatitis B or hepatitis C infection or excessive alcohol intake. Thousands of new cases have been prevented in the United States over the last two decades due to widespread hepatitis B vaccination and advances in screening and treatment for hepatitis B and C.

Despite this progress, liver cancer remains especially difficult to treat. However, the introduction of the first molecularly targeted drug for liver cancer in 2008 marked an important first chapter in what is expected to be a new era of liver cancer research and treatment. Researchers are hopeful that growing understanding of how liver cancer develops and grows will drive development of more targeted drugs that capitalize on the molecular vulnerabilities of liver cancer cells.
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2017

First immunotherapy for advanced liver cancer shrinks tumors

First immunotherapy for advanced liver cancer shrinks tumors

An early-stage clinical trial provides the first data suggesting that the PD-1-targeted immunotherapy nivolumab (Opdivo) may be beneficial in advanced hepatocellular carcinoma. Based on these findings, which show that nivolumab causes tumor shrinkage in a significant portion of patients, the FDA grants accelerated approval for use in patients previously treated with the targeted drug sorafenib (Nexavar).

More Information: 

Lancet 2017; 389:2492-2502
FDA Approval

2012

Routine hepatitis C screening recommended

Routine hepatitis C screening recommended

The U.S. Centers for Disease Control and Prevention proposes that all baby boomers (individuals born 1945-1965) be screened for the hepatitis C virus (HCV), as this group is five times more likely than other American adults to be infected and overall deaths due to HCV are on the rise.

Early diagnosis of HCV is vital, since the longer the virus goes undetected, the greater a person's risk of developing serious liver disease, including liver cancer and cirrhosis.

More Information: 

CDC Fact Sheet: Hepatitis C Testing

2008

Refined eligibility criteria for liver transplantation leads to longer survival

2007

First targeted therapy shown to be effective against liver cancer

First targeted therapy shown to be effective against liver cancer

For the first time in almost two decades, a large study shows that a new drug, in this case sorafenib (Nexavar), extends the lives of patients with advanced, inoperable hepatocellular carcinoma, the most common form of liver cancer. Sorafenib is the first targeted therapy proven effective for liver cancer and quickly becomes a standard treatment. The drug is approved by the FDA in 2007.

More Information: 

N Engl J Med 2008; 359: 378-390

2003

Obesity pinpointed as cause of many cancer deaths

Obesity pinpointed as cause of many cancer deaths

An important prospective analysis involving nearly 1 million Americans reports that obesity could account for up to 20 percent of U.S. cancer deaths. Obesity is linked to a higher risk of death from liver cancer, along with several other cancer types. The researchers also estimate that 90,000 cancer-related deaths could be prevented annually if Americans maintained a healthy weight.

As obesity becomes more prevalent, researchers project that deaths from liver cancer and other forms of the disease will rise as well.

More Information: 

N Engl J Med 2003; 348: 1625-38

2002

Key molecular pathways in liver cancer offer new insight

Key molecular pathways in liver cancer offer new insight

Caption

Researchers discover genetic pathways that govern liver cancer cell growth and development. The findings suggest that liver cancers develop as a result of disruptions along multiple pathways, resulting in many genetically varied forms of liver cancer. These findings explain why the development of gene-targeted drugs has proven so challenging over the past decade, but also provide researchers with a number of potential treatment targets to explore.

More Information: 

Nature Genetics 2002; 31: 339–346
Chemo-embolization offers improved survival for select patients

Chemo-embolization offers improved survival for select patients

Unlike other organs, the liver has two major sources of blood supply, instead of one. For unknown reasons, cancer only develops around the lower of these arteries, the hepatic artery, and uses this blood supply to fuel its growth. Doctors have long debated whether temporarily blocking – or embolizing – this artery to starve the tumor of blood can improve overall outcomes.

In 2002, two studies show that repeatedly (every 2-6 months) injecting the chemotherapy drug doxorubicin and then embolizing the hepatic artery increases survival in a set of patients whose tumors cannot be removed surgically. However, the approach is still debated by researchers, who question its overall impact.

More Information: 

Lancet 2002; 359(9319): 1734–1739
Hepatology 2003; 35(5): 1164-1171

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