| Theme |
Treatment Strategy for Advanced Hepatocellular Carcinoma |
| Title |
Imaging Diagnosis and Biomarkers in Patients with Advanced Hepatocellular Carcinoma |
| Author |
Kaoru Tsuchiya |
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital |
| Author |
Yutaka Yasui |
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital |
| Author |
Masayuki Kurosaki |
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital |
| Author |
Namiki Izumi |
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital |
| [ Summary ] |
Currently, evaluation of any therapeutic effect in advanced hepatocellular carcinoma (HCC) is performed using modified RECIST (response evaluation criteria in solid tumors) criteria and/or RECICL (response evaluation criteria in cancer of the liver), which depends on changes in tumor vascularity. The Choi criteria were used for patients with GIST (gastrointestinal stromal tumor) and in some reports, these criteria were more valuable than other criteria in patients treated with TARE (transarterial radioembolization). Further large scale prospective studies are necessary to verify the clinical usefulness of the Choi criteria in patients with advanced HCC. PET (positron emission tomogrphy)‒CT is useful for evaluating distant metastasis in advanced HCC, although there is no recommendation to use it for cancer screening. There is no established biomarker for advanced HCC except AFP (αfetoprotein), and the AFP level is within the normal range (<20 ng/ml) in about 30 % of patients with advanced HCC. In a phase II trial of a MET inhibitor, for patients with MET‒high tumors, the median time to progression was longer for patients treated with the MET inhibitor than for patients on placebo. In the near future, patients with advanced HCC would be expected to have a tumor biopsy before their treatment. We can then provide tailor‒made medical treatment and multidisciplinary therapy based on the expression of various genes and proteins in the individual tumor. |