Liver Cancer Abstracts

LIVER CANCER ABSTRACTS FROM THE AASLD MEETING IN SF 2008 FOR NATAP


AASLD Nov 2008 Authors:
Robert Gish MD and Catherine Frenette MDCPMC PROTEOMICS, GENOMICS AND BIOMARKERS:
"Initial proteomic analysis in hepatocellular carcinoma, identification of protein differences between normal and neoplastic tissues in cirrhotic and noncirrhotic patients." Abstract 434-AASLD, Pleguezuelo. For the management of HCC, investigators continue to explore the ability to determine risk of developing cancer, risk of progression once cancer is diagnosed and determine the overall prognosis in patients with HCC by looking at proteomic, genomic and biomarker analyses. In this abstract, a comparison was made between liver cancer tissue and non cancer surrounding tissue in cirrhotic and non cirrhotic patients. The investigators described a profile differential between cancer and noncancer tissue. The authors described that 12 proteins were up-regulated in tumor tissue in patients with cirrhosis and 4 proteins were up-regulated in patients with cancer without cirrhosis. A number of proteins were down regulated in HCC tissue, including a number of mitochondrial proteins. These newly described proteomic profiles may improve screening for HCC and subsequently improve the management of HCC by determining who is at risk of HCC and also determining who is at risk of more rapidly progressive disease. In addition, these tests may enhance the overall prognosis of patients with HCC and potentially permit clinicians to choose which therapeutic options for the treatment of hepatocellular carcinoma should be initiated. "Biomarkers predicting outcome in patients with hepatocellular carcinoma, results from random biopsies from the SHARP trial."Abstract 149-AASLD, Llovet. In this study, six plasma biomarkers, included VEGF, soluble VEGFR-2, VEGRF-3, C-KIT, hepatocyte growth factor (HGF) and RAF-21, and one tumor biomarker p-ERK were evaluated to assess survival or clinical correlation of sorafenib response with data extracted from the SHARP trial. Results of this study demonstrated that VEGF plasma levels were independently associated with overall survival in HCC patients treated with sorafenib. Low HGF levels and the high C-KIT levels were associated with longer survival in patients treated with sorafenib. Positive p-ERK staining in liver tissue and decreased levels of HGF in plasma after sorafenib therapy were associated with longer times to (slower) disease progression. This data gives further support to the use of serum biomarkers and liver tissue assessment to help assess patients for risk of disease progression and predict better response profiles. "Use of alpha fetoprotein and platelet count prediction of hepatocarcinogenesis in patients with hepatitis C." Abstract 506-AASLD, Tateyama. Biomarkers have an emerging role in the management of hepatocellular carcinoma. Alpha fetoprotein does not appear to be useful for screening, but alpha fetoprotein, alone or in combination with other biomarkers such as AFP-L3% and DCP, may predict an increased future risk of hepatocellular carcinoma or risk of recurrent disease after a specific intervention. In this study, the authors identified that an AFP greater than 20 ng/mL or an AFP above the "healthy levels" in the 6 to 20 range, indicates a future risk for hepatocellular carcinoma in patients with HCV. They further concluded that the combination of AFP and platelet count may result in useful information about when to initiate screening and when to intensify surveillance in patients who are at risk of HCC. "Novel fucosylated biomarkers for the early detection of hepatocellular carcinoma." Abstract 127-AASLD. Clinicians and researchers continue to look for better biomarkers to identify patients with an increased risk of hepatocellular carcinoma, when to perform surveillance for HCC, and biomarkers that may indicate an increased risk of recurrent disease after ablative therapies, resection, or transplantation. In this study of 277 patients, a new fucosylated AFP biomarker showed an improved performance, especially when the fucosylated hemopexin was combined with glycoprotein 73 (GP73) This panel had had a sensitivity of 100%, specificity of 85%, and an AUROC of 95% for the diagnosis of HCC. This data would lend support if we can further expand our biomarker panel to assist in the recognition of hepatocellular carcinoma in patient with a known liver mass.