What's New in Liver Cancer Research?

Written by American Cancer Society

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 being made in treating chronic hepatitis with drugs that make the patient's immune system stronger. Some believe that vaccinations 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 test used now. So far none of these has proved more helpful than the tests already in use.

Treatment

Surgery

Adding other treatments to surgery: New methods of surgery, both to remove the cancer and for transplants are being studied. For instance, doctors are looking at ways to treat and shrink the cancer before surgery. Early results look good, but only a small number of patients have been studied.

Another focus of research involves giving treatment after surgery to reduce the chances that the cancer will return. So far, the results have been mixed.

Doctors are also looking at laparoscopic surgery to treat liver cancer. Small cuts are made and the doctor uses long, thin tools to look at and cut out parts of the liver that have cancer. Right now, this is still an experimental treatment for liver cancer.

Looking at the risk of cancer coming back after surgery: After surgery, one of the biggest concerns is that the cancer will 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.

Radiation treatment

New methods of giving radiation for liver cancer are also being studied. Researchers are now working on ways to focus radiation only on the cancer, not the normal, healthy tissue. One area of research involves putting radioactive substances into the artery that goes to the liver (radioembolization). This way the treatment goes directly to the tumors. Another method uses tiny radioactive glass beads.

Targeted therapy

New drugs are being developed that work in a different way from standard chemo drugs. These newer drugs target exact parts of cancer cells.

Tumor blood vessels are the target of several newer drugs. Liver tumors need new blood vessels in order to grow beyond a certain size. The drug sorafenib (Nexavar®), which is already used for some liver cancers that can't be removed, works in part by keeping new blood vessel from forming. Some other drugs that target blood vessel growth are also being studied for use against liver cancer.

Other new drugs have different targets. For example, a drug called erlotinib (Tarceva®), which targets a protein called EGFR on cancer cells, has shown some benefit in people with advanced liver cancer in early studies. Several other targeted drugs are now being studied as well.

Chemo

New forms of chemo combined 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.

Newer chemo drugs, such as oxaliplatin, capecitabine, gemcitabine, and docetaxel, are now being used to treat liver cancer in clinical trials.

Another way researchers are trying to improve chemo is to give it straight into the hepatic artery, which supplies most liver tumors. The healthy liver then removes most of the remaining drug before it can reach the rest of the body.

While early studies have found that this method works in shrinking a number of tumors, more research is still needed. It may not be useful in all cases because surgery is often needed to put a catheter into the hepatic artery. This is an operation that many liver cancer patients may not be able to handle.

Gene therapy

Scientists are learning more about many of the genes that are damaged when normal cells become cancer. They hope to develop treatments that could replace the DNA of these genes. Clinical trials are being done to study this type of treatment as well as the side effects and short and long-term results.