//THE ONLINE Nurse
Diagnosis and Treatment of Hepatocellular Carcinoma
This 12-page PDF consists of an article from the journal Gastroenterology that reviews the diagnosis and treatment of liver cancer. It begins with a brief background of liver cancer before discussing the clinical features of and screening for the disease. It explores the available tests to use and which patient groups should be screened. Several images taken from an MRI accompany the information on diagnosing liver cancer. The focus moves to the importance of staging in making treatment decisions and lists several common staging systems for liver cancer. A proposed treatment algorithm is presented, with treatment modalities for the disease: surgical resection, liver transplantation, radiofrequency ablation, percutaneous ethanol injection, and transarterial chemoembolization. A table lists each modality, which patients each is appropriate for, and their average 1-, 3-, and 5-year survival rates. The article also summarizes additional treatment options and molecular therapies, such as angiogenesis inhibitors, growth-receptor signaling, and telomerase inhibition.
//THE EDUCATED PATIENT®
Liver Cancer Network
The Liver Cancer Network is a Website presented by The Liver Program at Allegheny General Hospital, Pittsburgh, Pennsylvania. The Website is designed to educate patients about the liver and liver cancer, and features sections such as “How the Liver Works,” which explains the anatomy as well as the digestive and circulatory functions of the liver. “How Liver Cancer Develops” summarizes liver cancer and describes cancer in general, carcinogenesis, and cancer growth. Under “Diagnosis,” visitors can read about how liver cancer is staged and find descriptions of the various tests used to diagnose it. The “Treatments” section provides descriptions of various liver cancer treatments, such as surgery, transplantation, radiotherapy, chemotherapy, and more. The Liver Cancer Network also features a “Web Resources” section with links to other websites containing useful information on liver disease, general health, and related support groups
Obstructions of portal veins and tumor numbers are associated with humped hepatocellular carcinoma
Journal: Acta Medica Okayama
Authors: Sanomura T, Ikeda F, Katoh T, et al
Purpose: A tumor protrusion in HCC is a sign of increased risk of tumor rupture, which can lead to recurrences after curative treatment. The purpose of this study was to determine the characteristics of humped HCC clinically and radiologically associated with liver damage, tumor progression, and treatment. The
179 patients with liver cancer included in the study underwent angiographic examination. The areas of the tumors were measured using MRI and helical computed tomography.
Results: The study found that the tumor-node-
metastasis (TNM) stage was significantly different between the humped and non-humped HCC groups. Humped HCC was more common in the right lobe, and an analysis of recurrent HCC showed that patients with multiple treatments of more than 4 sessions more frequently had humped HCC than those with 1 to 3 sessions. Multivariate regression analysis showed that tumor invasion in the portal vein, rather than large tumor size, was significantly associated with tumor protrusion. The authors concluded that HCC recurrence with humped HCC is more common in patients with multiple treatments, and that tumor factors of the TNM classification—especially tumor invasion in the portal vein—may be associated with tumor protrusion in liver cancer.
AZD6244 in treating patients with locally advanced or metastatic liver cancer
Study Type: Interventional
Age/Sex Requirements: 18 years (None)
Sponsor: H. Lee Moffitt Cancer
Center and Research Institute
ClinicalTrials.gov Identifier: NCT00550719
Purpose: This phase II study will be testing AZD6244, an inhibitor of the mitogen-activated protein kinase/extracellular signal-regulated kinase (MEK), in the treatment of locally advanced or metastatic liver cancer. Patients will receive a single dose of AZD6244 on day 1 of the study and, beginning 48 hours later, will receive oral AZD6244 twice daily until day 21. Patients will undergo frequent blood testing for pharmacokinetic sampling during the first 48 hours and on day 15; concentrations of AZD6244 in the blood are quantified by high performance liquid chromatography. Tumor biopsy is done at baseline and on day 8. Patients will receive AZD6244 on days 1–21 and the treatment repeats (in the absence of disease progression or unacceptable toxicity) every 21 days. The primary outcome measure of the study is the objective response rate.
Dasatinib in treating patients with advanced liver cancer that cannot be removed by surgery
Age/Sex Requirements: 18 years (None)
Sponsor: California Cancer Consortium
Purpose: Dasatinib (Sprycel) is a tyrosine kinase inhibitor that recently received accelerated approval from the FDA for the treatment of newly diagnosed adult patients with Philadelphia chromosome–positive chronic myeloid leukemia in chronic phase. This open-label, single group assignment phase II trial is testing the efficacy of dasatinib in treating patients with advanced liver tumors that cannot be taken out through surgery. The primary outcome measures are progression-free survival (PFS) and complete and partial response rates at 4 months. Secondary outcome measures include median PFS and overall survival, as well as toxicity and tolerability. Patients will be administered dasatinib orally twice daily for 28-day cycles. Follow-up will occur at 4 weeks and then every 3 to 6 months. The trial, which aims to accrue a total of 41 patients, is being conducted at multiple sites throughout the United States.