What`s new in liver cancer research?

There is always research going on in the area of liver cancer. Scientists are looking at the causes of liver cancer, ways to prevent it, and ways to improve treatments.

Prevention

Researchers are looking at ways to prevent or treat hepatitis before it causes liver cancer. Research is being done to make a vaccine to prevent hepatitis C. Progress is also being made in treating chronic hepatitis with drugs that make the patient's immune system stronger. Some believe that vaccines and better treatments for hepatitis could prevent about half of liver cancer cases worldwide.

Finding liver cancer early

Some new blood tests are being studied to see if they can find liver cancer earlier than the tests used now.

Treatment

Surgery

Newer methods are being explored to make all kinds of liver surgery safer and more effective.

Adding other treatments to surgery: Doctors are looking at ways to shrink liver cancers so that they can be removed with surgery. Early results look good, but only a small number of patients have been studied so far.

Another focus of research involves giving treatment after surgery to reduce the chances that the cancer will return.

Laparoscopic surgery: Doctors are also looking at laparoscopic surgery to treat liver cancer. Small cuts are made in the belly (abdomen) and the doctor uses long, thin tools to look at and cut out parts of the liver that have cancer. This type of surgery may result in less blood loss, less pain after surgery, and a quicker recovery. Right now, this is still an experimental treatment for certain liver cancers.

Looking at the risk of cancer coming back after surgery: After surgery, one of the biggest concerns is that the cancer might come back (recur). Knowing someone's risk for recurrence after surgery might give doctors a better idea of how best to follow up with them. Someday this may also help them decide who needs more treatment to lower this risk.

Researchers may have found a way to do this by testing the cells in the surgery sample. They have looked at the pattern of genes in liver cells near the tumor (not the tumor cells themselves) and were able to predict which patients were at higher risk for the cancer coming back. This is an early finding that will need to be confirmed in other studies before it is widely used.

Liver transplant: Only a small portion of patients with liver cancer can be considered for a liver transplant at this time because of the strict rules they need to meet (based mainly on the size and number of tumors). Some doctors are now looking to see if these rules can be enlarged, so that people who are fairly healthy but have slightly larger tumors might also be eligible.

Even for people who are eligible, there can be a long wait before a liver becomes available. Doctors are looking at using other treatments, such as ablation, to help keep the cancer in check until a new liver is available.

Radiation treatment

The main problem with using radiation against liver cancer is that it also harms healthy liver tissue. Researchers are now working on ways to focus radiation just on the cancer, sparing the nearby normal liver tissue. Some new methods of giving radiation are being tried, such as using drugs (called radiosensitizers) that make cancers more open to radiation.

Targeted therapy

New drugs are being made that work in a different way from standard chemo drugs. These newer drugs are aimed at (target) exact parts of cancer cells.

Tumor blood vessels are the target of some newer drugs. Liver tumors need new blood vessels in order to grow. The drug sorafenib (Nexavar^®), which is already used for some liver cancers that can't be removed, works in part by keeping new blood vessels from forming. This drug is now being studied for use earlier in the course of the disease. Doctors are also looking at whether giving it along with chemo or with other targeted drugs may help it work better.

Bevacizumab (Avastin^®) and other drugs that target blood vessel growth are also being studied for use against liver cancer.

Some new drugs have different targets. For instance, a drug called erlotinib (Tarceva^®), which targets a protein called EGFR on cancer cells, has shown to help some people with advanced liver cancer in early studies. Other targeted drugs are being studied, too.

Chemotherapy

New forms of chemotherapy, used along with other treatments, are being tested in clinical trials. A small number of tumors respond to chemo, but chemo has not yet been shown to help patients live longer.

Virus therapy

A newer approach to treatment is the use of a virus known as JX-594. This is the same virus that was used to make the smallpox vaccine, but it has been altered in the lab so that it mainly infects cancer cells and not normal cells. It is injected into the blood and enters the cancer cells, where it causes them to die or to make proteins that result in them being attacked by the body’s immune system.

Early results against advanced liver cancer have been promising, even in patients who have already had other treatments, and larger studies of this treatment are now being done.