Hepatocellular Carcinoma

Key clinical point: Active hepatitis C virus (HCV) infection negatively affects overall and recurrence-free survival in patients with very early-stage hepatocellular carcinoma (HCC) after curative radiofrequency ablation (RFA).

Major finding: Active HCV infection was a significant risk factor for shorter overall survival (adjusted hazard ratio [aHR] 2.17; P = .003) and early recurrence of HCC (aHR 1.47; P = .022). Patients with vs. without active HCV infection had a shorter median overall (66 months vs. 145 months) and recurrence-free (20 months vs. 31 months) survival (both P < .001).

Study details: Findings are from a single-center retrospective study including 302 patients with very early-stage HCC (Barcelona Clinic Liver Cancer stage 0) who underwent RFA and had follow-up of >6 months, of which 195 had HCV infection, including 132 active infection cases.

Disclosures: M Kurosaki and N Izumi declared funding support from the Japan Agency for Medical Research and Development and Japanese Ministry of Health, Welfare, and Labor, respectively, and along with K Tsuchiya, receiving lecture fees from several sources.

Source: Takaura K et al. The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy. PLoS One. 2022;17(2):e0264075 (Feb 23). Doi:  10.1371/journal.pone.0264075

Key clinical point: Active hepatitis C virus (HCV) infection negatively affects overall and recurrence-free survival in patients with very early-stage hepatocellular carcinoma (HCC) after curative radiofrequency ablation (RFA).

Major finding: Active HCV infection was a significant risk factor for shorter overall survival (adjusted hazard ratio [aHR] 2.17; P = .003) and early recurrence of HCC (aHR 1.47; P = .022). Patients with vs. without active HCV infection had a shorter median overall (66 months vs. 145 months) and recurrence-free (20 months vs. 31 months) survival (both P < .001).

Study details: Findings are from a single-center retrospective study including 302 patients with very early-stage HCC (Barcelona Clinic Liver Cancer stage 0) who underwent RFA and had follow-up of >6 months, of which 195 had HCV infection, including 132 active infection cases.

Disclosures: M Kurosaki and N Izumi declared funding support from the Japan Agency for Medical Research and Development and Japanese Ministry of Health, Welfare, and Labor, respectively, and along with K Tsuchiya, receiving lecture fees from several sources.

Source: Takaura K et al. The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy. PLoS One. 2022;17(2):e0264075 (Feb 23). Doi:  10.1371/journal.pone.0264075

Key clinical point: Active hepatitis C virus (HCV) infection negatively affects overall and recurrence-free survival in patients with very early-stage hepatocellular carcinoma (HCC) after curative radiofrequency ablation (RFA).

Major finding: Active HCV infection was a significant risk factor for shorter overall survival (adjusted hazard ratio [aHR] 2.17; P = .003) and early recurrence of HCC (aHR 1.47; P = .022). Patients with vs. without active HCV infection had a shorter median overall (66 months vs. 145 months) and recurrence-free (20 months vs. 31 months) survival (both P < .001).

Study details: Findings are from a single-center retrospective study including 302 patients with very early-stage HCC (Barcelona Clinic Liver Cancer stage 0) who underwent RFA and had follow-up of >6 months, of which 195 had HCV infection, including 132 active infection cases.

Disclosures: M Kurosaki and N Izumi declared funding support from the Japan Agency for Medical Research and Development and Japanese Ministry of Health, Welfare, and Labor, respectively, and along with K Tsuchiya, receiving lecture fees from several sources.

Source: Takaura K et al. The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy. PLoS One. 2022;17(2):e0264075 (Feb 23). Doi:  10.1371/journal.pone.0264075

Key clinical point: Independent risk factors for postoperative recurrence among patients undergoing curative hepatic resection for early-stage hepatocellular carcinoma (HCC) include preoperative alpha-fetoprotein (AFP) level >400 µg/L, tumor size >5 cm, satellite nodules, multiple tumors, and microvascular invasion.

Major finding: Cirrhosis (adjusted hazard ratio [aHR] 1.49; P < .001), preoperative AFP level >400 µg/L (aHR 1.28; P = .004), tumor size >5 cm (aHR 1.74; P < .001), satellite nodules (aHR 1.35; P = .040), multiple tumors (aHR 1.63; P = .015), microvascular invasion (aHR 1.51; P < .001), and intraoperative blood transfusion (aHR 1.50; P = .013) were identified as independent risk factors associated with postoperative recurrence.

Study details: The data come from a large-scale, multicenter retrospective study including 1,424 adult patients who underwent curative hepatic resection for early-stage HCC (Barcelona Clinic Liver Cancer stage 0/A).

Disclosures: The study was supported by the National Natural Science Foundation of China. The authors reported no conflict of interests.

Source: Yao L-Q et al. Clinical features of recurrence after hepatic resection for early-stage hepatocellular carcinoma and long-term survival outcomes of patients with recurrence: A multi-institutional analysis. Ann Surg Oncol. 2022 Feb 22. Doi: 10.1245/s10434-022-11454-y

Key clinical point: Independent risk factors for postoperative recurrence among patients undergoing curative hepatic resection for early-stage hepatocellular carcinoma (HCC) include preoperative alpha-fetoprotein (AFP) level >400 µg/L, tumor size >5 cm, satellite nodules, multiple tumors, and microvascular invasion.

Major finding: Cirrhosis (adjusted hazard ratio [aHR] 1.49; P < .001), preoperative AFP level >400 µg/L (aHR 1.28; P = .004), tumor size >5 cm (aHR 1.74; P < .001), satellite nodules (aHR 1.35; P = .040), multiple tumors (aHR 1.63; P = .015), microvascular invasion (aHR 1.51; P < .001), and intraoperative blood transfusion (aHR 1.50; P = .013) were identified as independent risk factors associated with postoperative recurrence.

Study details: The data come from a large-scale, multicenter retrospective study including 1,424 adult patients who underwent curative hepatic resection for early-stage HCC (Barcelona Clinic Liver Cancer stage 0/A).

Disclosures: The study was supported by the National Natural Science Foundation of China. The authors reported no conflict of interests.

Source: Yao L-Q et al. Clinical features of recurrence after hepatic resection for early-stage hepatocellular carcinoma and long-term survival outcomes of patients with recurrence: A multi-institutional analysis. Ann Surg Oncol. 2022 Feb 22. Doi: 10.1245/s10434-022-11454-y

Key clinical point: Independent risk factors for postoperative recurrence among patients undergoing curative hepatic resection for early-stage hepatocellular carcinoma (HCC) include preoperative alpha-fetoprotein (AFP) level >400 µg/L, tumor size >5 cm, satellite nodules, multiple tumors, and microvascular invasion.

Major finding: Cirrhosis (adjusted hazard ratio [aHR] 1.49; P < .001), preoperative AFP level >400 µg/L (aHR 1.28; P = .004), tumor size >5 cm (aHR 1.74; P < .001), satellite nodules (aHR 1.35; P = .040), multiple tumors (aHR 1.63; P = .015), microvascular invasion (aHR 1.51; P < .001), and intraoperative blood transfusion (aHR 1.50; P = .013) were identified as independent risk factors associated with postoperative recurrence.

Study details: The data come from a large-scale, multicenter retrospective study including 1,424 adult patients who underwent curative hepatic resection for early-stage HCC (Barcelona Clinic Liver Cancer stage 0/A).

Disclosures: The study was supported by the National Natural Science Foundation of China. The authors reported no conflict of interests.

Source: Yao L-Q et al. Clinical features of recurrence after hepatic resection for early-stage hepatocellular carcinoma and long-term survival outcomes of patients with recurrence: A multi-institutional analysis. Ann Surg Oncol. 2022 Feb 22. Doi: 10.1245/s10434-022-11454-y

Key clinical point: Hampered ultrasound visualization in patients with cirrhosis receiving hepatocellular carcinoma (HCC) surveillance is associated with worse test performance, negatively affecting both sensitivity and specificity of surveillance.

Major finding: Patients with cirrhosis and HCC having severely impaired ultrasound visualization before HCC diagnosis showed increased odds of false-negative results (adjusted odds ratio [aOR] 7.94; 95% CI 1.23-51.16), whereas those with only cirrhosis having moderately impaired visualization showed increased odds of false-positive results (aOR 1.60; 95% CI 1.13-2.27).

Study details: This was a retrospective cohort study involving 2,238 patients with cirrhosis, with (n = 186) or without (n = 2,052) HCC, who underwent at least one abdominal ultrasound examination.

Disclosures: The study was supported by the United States National Institute of Health. A Singal and D Fetzer declared serving as consultants or advisory board members of or having research agreements with various organizations.

Source: Chong N et al. Association between ultrasound quality and test performance for HCC surveillance in patients with cirrhosis: a retrospective cohort study. Aliment Pharmacol Ther. 2022;55(6):683-690 (Feb 15). Doi: 10.1111/apt.16779

Key clinical point: Hampered ultrasound visualization in patients with cirrhosis receiving hepatocellular carcinoma (HCC) surveillance is associated with worse test performance, negatively affecting both sensitivity and specificity of surveillance.

Major finding: Patients with cirrhosis and HCC having severely impaired ultrasound visualization before HCC diagnosis showed increased odds of false-negative results (adjusted odds ratio [aOR] 7.94; 95% CI 1.23-51.16), whereas those with only cirrhosis having moderately impaired visualization showed increased odds of false-positive results (aOR 1.60; 95% CI 1.13-2.27).

Study details: This was a retrospective cohort study involving 2,238 patients with cirrhosis, with (n = 186) or without (n = 2,052) HCC, who underwent at least one abdominal ultrasound examination.

Disclosures: The study was supported by the United States National Institute of Health. A Singal and D Fetzer declared serving as consultants or advisory board members of or having research agreements with various organizations.

Source: Chong N et al. Association between ultrasound quality and test performance for HCC surveillance in patients with cirrhosis: a retrospective cohort study. Aliment Pharmacol Ther. 2022;55(6):683-690 (Feb 15). Doi: 10.1111/apt.16779

Key clinical point: Hampered ultrasound visualization in patients with cirrhosis receiving hepatocellular carcinoma (HCC) surveillance is associated with worse test performance, negatively affecting both sensitivity and specificity of surveillance.

Major finding: Patients with cirrhosis and HCC having severely impaired ultrasound visualization before HCC diagnosis showed increased odds of false-negative results (adjusted odds ratio [aOR] 7.94; 95% CI 1.23-51.16), whereas those with only cirrhosis having moderately impaired visualization showed increased odds of false-positive results (aOR 1.60; 95% CI 1.13-2.27).

Study details: This was a retrospective cohort study involving 2,238 patients with cirrhosis, with (n = 186) or without (n = 2,052) HCC, who underwent at least one abdominal ultrasound examination.

Disclosures: The study was supported by the United States National Institute of Health. A Singal and D Fetzer declared serving as consultants or advisory board members of or having research agreements with various organizations.

Source: Chong N et al. Association between ultrasound quality and test performance for HCC surveillance in patients with cirrhosis: a retrospective cohort study. Aliment Pharmacol Ther. 2022;55(6):683-690 (Feb 15). Doi: 10.1111/apt.16779

Key clinical point: Magnetic resonance elastography (MRE)-based shear strain mapping may serve as a noninvasive biomarker enabling the characterization of the tumor-liver interface and preoperative prediction of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).

Major finding: The positive MVI vs. negative MVI group displayed a significantly higher octahedral shear strain (OSS) percentage of low-shear-strain length (pLSL) at three evaluation frequencies (60 Hz: 75% vs. 40%, 40 Hz: 85% vs. 40%, and 30 Hz: 70% vs. 20%; all P < .01). The peritumor OSS-pLSL area under the receiver operating characteristic curve (0.73-0.90) for MVI prediction was good/excellent at all frequencies.

Study details: The data are derived from a retrospective study of 59 patients with HCC, all of whom underwent the conventional 60 Hz MRE examination; of these, 29 patients also underwent 40 and 30 Hz MRE examinations.

Disclosures: The study was funded by the National Natural Science Foundation of China, among others. The authors declared no conflict of interests.

Source: Li M et al. MR elastography-based shear strain mapping for assessment of microvascular invasion in hepatocellular carcinoma. Eur Radiol. 2022 (Feb 11). Doi: 10.1007/s00330-022-08578-w

Key clinical point: Magnetic resonance elastography (MRE)-based shear strain mapping may serve as a noninvasive biomarker enabling the characterization of the tumor-liver interface and preoperative prediction of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).

Major finding: The positive MVI vs. negative MVI group displayed a significantly higher octahedral shear strain (OSS) percentage of low-shear-strain length (pLSL) at three evaluation frequencies (60 Hz: 75% vs. 40%, 40 Hz: 85% vs. 40%, and 30 Hz: 70% vs. 20%; all P < .01). The peritumor OSS-pLSL area under the receiver operating characteristic curve (0.73-0.90) for MVI prediction was good/excellent at all frequencies.

Study details: The data are derived from a retrospective study of 59 patients with HCC, all of whom underwent the conventional 60 Hz MRE examination; of these, 29 patients also underwent 40 and 30 Hz MRE examinations.

Disclosures: The study was funded by the National Natural Science Foundation of China, among others. The authors declared no conflict of interests.

Source: Li M et al. MR elastography-based shear strain mapping for assessment of microvascular invasion in hepatocellular carcinoma. Eur Radiol. 2022 (Feb 11). Doi: 10.1007/s00330-022-08578-w

Key clinical point: Magnetic resonance elastography (MRE)-based shear strain mapping may serve as a noninvasive biomarker enabling the characterization of the tumor-liver interface and preoperative prediction of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).

Major finding: The positive MVI vs. negative MVI group displayed a significantly higher octahedral shear strain (OSS) percentage of low-shear-strain length (pLSL) at three evaluation frequencies (60 Hz: 75% vs. 40%, 40 Hz: 85% vs. 40%, and 30 Hz: 70% vs. 20%; all P < .01). The peritumor OSS-pLSL area under the receiver operating characteristic curve (0.73-0.90) for MVI prediction was good/excellent at all frequencies.

Study details: The data are derived from a retrospective study of 59 patients with HCC, all of whom underwent the conventional 60 Hz MRE examination; of these, 29 patients also underwent 40 and 30 Hz MRE examinations.

Disclosures: The study was funded by the National Natural Science Foundation of China, among others. The authors declared no conflict of interests.

Source: Li M et al. MR elastography-based shear strain mapping for assessment of microvascular invasion in hepatocellular carcinoma. Eur Radiol. 2022 (Feb 11). Doi: 10.1007/s00330-022-08578-w

Key clinical point: Patients with advanced hepatocellular carcinoma (aHCC) and alpha-fetoprotein (AFP) levels ≥400 ng/mL experience a consistent survival benefit with ramucirumab therapy irrespective of baseline prognostic covariates.

Major finding: Ramucirumab vs. placebo improved overall survival in patients with viral (hazard ratio [HR] 0.76; 95% CI 0.60-0.97) and nonviral (HR 0.56; 95% CI 0.49-0.79) etiologies and in those with above-median AFP levels (≥4,081.5 ng/mL; HR 0.71; 95% CI 0.54-0.95).

Study details: Findings are from a post hoc meta-analysis of the phase 3 REACH and REACH-2 trials involving 542 patients with aHCC and AFP levels ≥400 ng/mL who were randomly assigned to receive ramucirumab (n = 316) or placebo (n = 226).

Disclosures: The study was sponsored by Eli Lilly and Company. JM Llovet, A Singal, A Villanueva, R Finn, M Kudo, P Galle, M Ikeda, and A Zhu reported receiving grants, personal/advisory board/consulting fees, or honoraria from various sources, including Eli Lilly. The other authors are employees or shareholders of Eli Lilly.

Source: Llovet JM et al. Prognostic and predictive factors in patients with advanced HCC and elevated alpha-fetoprotein treated with ramucirumab in two randomized phase III trial. Clin Cancer Res. 2022 (Mar 4). Doi: 10.1158/1078-0432.CCR-21-4000

Key clinical point: Patients with advanced hepatocellular carcinoma (aHCC) and alpha-fetoprotein (AFP) levels ≥400 ng/mL experience a consistent survival benefit with ramucirumab therapy irrespective of baseline prognostic covariates.

Major finding: Ramucirumab vs. placebo improved overall survival in patients with viral (hazard ratio [HR] 0.76; 95% CI 0.60-0.97) and nonviral (HR 0.56; 95% CI 0.49-0.79) etiologies and in those with above-median AFP levels (≥4,081.5 ng/mL; HR 0.71; 95% CI 0.54-0.95).

Study details: Findings are from a post hoc meta-analysis of the phase 3 REACH and REACH-2 trials involving 542 patients with aHCC and AFP levels ≥400 ng/mL who were randomly assigned to receive ramucirumab (n = 316) or placebo (n = 226).

Disclosures: The study was sponsored by Eli Lilly and Company. JM Llovet, A Singal, A Villanueva, R Finn, M Kudo, P Galle, M Ikeda, and A Zhu reported receiving grants, personal/advisory board/consulting fees, or honoraria from various sources, including Eli Lilly. The other authors are employees or shareholders of Eli Lilly.

Source: Llovet JM et al. Prognostic and predictive factors in patients with advanced HCC and elevated alpha-fetoprotein treated with ramucirumab in two randomized phase III trial. Clin Cancer Res. 2022 (Mar 4). Doi: 10.1158/1078-0432.CCR-21-4000

Key clinical point: Patients with advanced hepatocellular carcinoma (aHCC) and alpha-fetoprotein (AFP) levels ≥400 ng/mL experience a consistent survival benefit with ramucirumab therapy irrespective of baseline prognostic covariates.

Major finding: Ramucirumab vs. placebo improved overall survival in patients with viral (hazard ratio [HR] 0.76; 95% CI 0.60-0.97) and nonviral (HR 0.56; 95% CI 0.49-0.79) etiologies and in those with above-median AFP levels (≥4,081.5 ng/mL; HR 0.71; 95% CI 0.54-0.95).

Study details: Findings are from a post hoc meta-analysis of the phase 3 REACH and REACH-2 trials involving 542 patients with aHCC and AFP levels ≥400 ng/mL who were randomly assigned to receive ramucirumab (n = 316) or placebo (n = 226).

Disclosures: The study was sponsored by Eli Lilly and Company. JM Llovet, A Singal, A Villanueva, R Finn, M Kudo, P Galle, M Ikeda, and A Zhu reported receiving grants, personal/advisory board/consulting fees, or honoraria from various sources, including Eli Lilly. The other authors are employees or shareholders of Eli Lilly.

Source: Llovet JM et al. Prognostic and predictive factors in patients with advanced HCC and elevated alpha-fetoprotein treated with ramucirumab in two randomized phase III trial. Clin Cancer Res. 2022 (Mar 4). Doi: 10.1158/1078-0432.CCR-21-4000

Key clinical point: Compared with patients with hepatocellular carcinoma (HCC) due to other causes, a higher proportion of those with nonalcoholic fatty liver disease (NAFLD)-related HCC do not have cirrhosis and lack an indication for HCC surveillance, thus calling for surveillance strategies for patients with NAFLD without cirrhosis but at high risk for HCC.

Major finding: The proportion of patients without cirrhosis was higher among those with NAFLD-related HCC vs. HCC due to other causes (38.5% vs. 14.6%; P < .0001). Before cancer diagnosis, only 32.8% of patients with NAFLD-related HCC underwent HCC surveillance relative to 55.7% of those with HCC due to other causes (odds ratio 0.36; P < .0001).

Study details: This was a meta-analysis of 61 studies including 94,636 patients with HCC related to either NAFLD (n = 15,377) or other causes (n = 79,259).

Disclosures: No funding was received for the study. Some authors declared having stock options from, serving as paid/unpaid consultants or advisory board members for, and receiving royalties or research grants from various organizations.

Source: Tan DJH et al. Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: a systematic review and meta-analysis. Lancet Oncol. 2022 (Mar 4). Doi: 10.1016/S1470-2045(22)00078-X

Key clinical point: Compared with patients with hepatocellular carcinoma (HCC) due to other causes, a higher proportion of those with nonalcoholic fatty liver disease (NAFLD)-related HCC do not have cirrhosis and lack an indication for HCC surveillance, thus calling for surveillance strategies for patients with NAFLD without cirrhosis but at high risk for HCC.

Major finding: The proportion of patients without cirrhosis was higher among those with NAFLD-related HCC vs. HCC due to other causes (38.5% vs. 14.6%; P < .0001). Before cancer diagnosis, only 32.8% of patients with NAFLD-related HCC underwent HCC surveillance relative to 55.7% of those with HCC due to other causes (odds ratio 0.36; P < .0001).

Study details: This was a meta-analysis of 61 studies including 94,636 patients with HCC related to either NAFLD (n = 15,377) or other causes (n = 79,259).

Disclosures: No funding was received for the study. Some authors declared having stock options from, serving as paid/unpaid consultants or advisory board members for, and receiving royalties or research grants from various organizations.

Source: Tan DJH et al. Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: a systematic review and meta-analysis. Lancet Oncol. 2022 (Mar 4). Doi: 10.1016/S1470-2045(22)00078-X

Key clinical point: Compared with patients with hepatocellular carcinoma (HCC) due to other causes, a higher proportion of those with nonalcoholic fatty liver disease (NAFLD)-related HCC do not have cirrhosis and lack an indication for HCC surveillance, thus calling for surveillance strategies for patients with NAFLD without cirrhosis but at high risk for HCC.

Major finding: The proportion of patients without cirrhosis was higher among those with NAFLD-related HCC vs. HCC due to other causes (38.5% vs. 14.6%; P < .0001). Before cancer diagnosis, only 32.8% of patients with NAFLD-related HCC underwent HCC surveillance relative to 55.7% of those with HCC due to other causes (odds ratio 0.36; P < .0001).

Study details: This was a meta-analysis of 61 studies including 94,636 patients with HCC related to either NAFLD (n = 15,377) or other causes (n = 79,259).

Disclosures: No funding was received for the study. Some authors declared having stock options from, serving as paid/unpaid consultants or advisory board members for, and receiving royalties or research grants from various organizations.

Source: Tan DJH et al. Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: a systematic review and meta-analysis. Lancet Oncol. 2022 (Mar 4). Doi: 10.1016/S1470-2045(22)00078-X

Key clinical point: Lenvatinib (LEN)-transcatheter arterial chemoembolization (LEN-TACE) sequential therapy may be more clinically beneficial than LEN monotherapy in patients with unresectable hepatocellular carcinoma (HCC) responsive to initial LEN treatment without exerting any additional adverse effects.

Major finding: The LEN-TACE vs. LEN monotherapy group showed a significantly higher median overall survival (31.2 months vs. 13.9 months; P = .002) and progression-free survival (12.2 months vs. 7.1 months; P = .037). The LEN-TACE group had an acceptable safety profile, with only liver dysfunction being significantly higher (P = .04).

Study details: Findings are from a retrospective, multicenter cohort study on patients with intermediate- or advanced-stage unresectable HCC who responded to initial LEN treatment. Among these, 63 patients receiving LEN-TACE sequential therapy were propensity-score matched to those receiving LEN monotherapy.

Disclosures: The authors declared no source of funding or conflict of interests.

Source: Kuroda H et al. Objective response by mRECIST to initial lenvatinib therapy is an independent factor contributing to deep response in hepatocellular carcinoma treated with lenvatinib-transcatheter arterial chemoembolization sequential therapy. Liver Cancer. 2022 (Feb 15). Doi: 10.1159/000522424

Key clinical point: Lenvatinib (LEN)-transcatheter arterial chemoembolization (LEN-TACE) sequential therapy may be more clinically beneficial than LEN monotherapy in patients with unresectable hepatocellular carcinoma (HCC) responsive to initial LEN treatment without exerting any additional adverse effects.

Major finding: The LEN-TACE vs. LEN monotherapy group showed a significantly higher median overall survival (31.2 months vs. 13.9 months; P = .002) and progression-free survival (12.2 months vs. 7.1 months; P = .037). The LEN-TACE group had an acceptable safety profile, with only liver dysfunction being significantly higher (P = .04).

Study details: Findings are from a retrospective, multicenter cohort study on patients with intermediate- or advanced-stage unresectable HCC who responded to initial LEN treatment. Among these, 63 patients receiving LEN-TACE sequential therapy were propensity-score matched to those receiving LEN monotherapy.

Disclosures: The authors declared no source of funding or conflict of interests.

Source: Kuroda H et al. Objective response by mRECIST to initial lenvatinib therapy is an independent factor contributing to deep response in hepatocellular carcinoma treated with lenvatinib-transcatheter arterial chemoembolization sequential therapy. Liver Cancer. 2022 (Feb 15). Doi: 10.1159/000522424

Key clinical point: Lenvatinib (LEN)-transcatheter arterial chemoembolization (LEN-TACE) sequential therapy may be more clinically beneficial than LEN monotherapy in patients with unresectable hepatocellular carcinoma (HCC) responsive to initial LEN treatment without exerting any additional adverse effects.

Major finding: The LEN-TACE vs. LEN monotherapy group showed a significantly higher median overall survival (31.2 months vs. 13.9 months; P = .002) and progression-free survival (12.2 months vs. 7.1 months; P = .037). The LEN-TACE group had an acceptable safety profile, with only liver dysfunction being significantly higher (P = .04).

Study details: Findings are from a retrospective, multicenter cohort study on patients with intermediate- or advanced-stage unresectable HCC who responded to initial LEN treatment. Among these, 63 patients receiving LEN-TACE sequential therapy were propensity-score matched to those receiving LEN monotherapy.

Disclosures: The authors declared no source of funding or conflict of interests.

Source: Kuroda H et al. Objective response by mRECIST to initial lenvatinib therapy is an independent factor contributing to deep response in hepatocellular carcinoma treated with lenvatinib-transcatheter arterial chemoembolization sequential therapy. Liver Cancer. 2022 (Feb 15). Doi: 10.1159/000522424

Key clinical point: Although treatment with transarterial chemoembolization (TACE) plus sorafenib does not significantly increase overall survival (OS) in patients with unresectable hepatocellular carcinoma (HCC) relative to TACE alone, it does offer a clinically meaningful OS prolongation.

Major finding: Patients receiving TACE plus sorafenib vs. TACE monotherapy showed a median OS of 36.2 months vs. 30.8 months (hazard ratio 0.861; P = .40). Despite being nonsignificant, the benefit (ΔOS 5.4 months) was clinically meaningful.

Study details: The data represent the final results of the multicenter, prospective phase 2 TACTICS trial including 156 patients aged >20 years with unresectable HCC having a life expectancy of ≥12 weeks who were randomly assigned to TACE plus sorafenib (n = 80) or TACE alone (n = 76).

Disclosures: The study was sponsored by Bayer Yakuhin Ltd., Japan. Some authors reported serving as speakers/advisory consultants for and receiving grants, personal fees, and consulting/advisory fees from various sources including Bayer. M Kudo is the Editor-in-Chief of Liver Cancer, and some others are its editorial board members.

Source: Kudo M et al. Final results of TACTICS: A randomized, prospective trial comparing transarterial chemoembolization plus sorafenib to transarterial chemoembolization alone in patients with unresectable hepatocellular carcinoma. Liver Cancer. 2022 (Feb 10). Doi: 10.1159/000522547

Key clinical point: Although treatment with transarterial chemoembolization (TACE) plus sorafenib does not significantly increase overall survival (OS) in patients with unresectable hepatocellular carcinoma (HCC) relative to TACE alone, it does offer a clinically meaningful OS prolongation.

Major finding: Patients receiving TACE plus sorafenib vs. TACE monotherapy showed a median OS of 36.2 months vs. 30.8 months (hazard ratio 0.861; P = .40). Despite being nonsignificant, the benefit (ΔOS 5.4 months) was clinically meaningful.

Study details: The data represent the final results of the multicenter, prospective phase 2 TACTICS trial including 156 patients aged >20 years with unresectable HCC having a life expectancy of ≥12 weeks who were randomly assigned to TACE plus sorafenib (n = 80) or TACE alone (n = 76).

Disclosures: The study was sponsored by Bayer Yakuhin Ltd., Japan. Some authors reported serving as speakers/advisory consultants for and receiving grants, personal fees, and consulting/advisory fees from various sources including Bayer. M Kudo is the Editor-in-Chief of Liver Cancer, and some others are its editorial board members.

Source: Kudo M et al. Final results of TACTICS: A randomized, prospective trial comparing transarterial chemoembolization plus sorafenib to transarterial chemoembolization alone in patients with unresectable hepatocellular carcinoma. Liver Cancer. 2022 (Feb 10). Doi: 10.1159/000522547

Key clinical point: Although treatment with transarterial chemoembolization (TACE) plus sorafenib does not significantly increase overall survival (OS) in patients with unresectable hepatocellular carcinoma (HCC) relative to TACE alone, it does offer a clinically meaningful OS prolongation.

Major finding: Patients receiving TACE plus sorafenib vs. TACE monotherapy showed a median OS of 36.2 months vs. 30.8 months (hazard ratio 0.861; P = .40). Despite being nonsignificant, the benefit (ΔOS 5.4 months) was clinically meaningful.

Study details: The data represent the final results of the multicenter, prospective phase 2 TACTICS trial including 156 patients aged >20 years with unresectable HCC having a life expectancy of ≥12 weeks who were randomly assigned to TACE plus sorafenib (n = 80) or TACE alone (n = 76).

Disclosures: The study was sponsored by Bayer Yakuhin Ltd., Japan. Some authors reported serving as speakers/advisory consultants for and receiving grants, personal fees, and consulting/advisory fees from various sources including Bayer. M Kudo is the Editor-in-Chief of Liver Cancer, and some others are its editorial board members.

Source: Kudo M et al. Final results of TACTICS: A randomized, prospective trial comparing transarterial chemoembolization plus sorafenib to transarterial chemoembolization alone in patients with unresectable hepatocellular carcinoma. Liver Cancer. 2022 (Feb 10). Doi: 10.1159/000522547

Key clinical point: Patients receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) after curative liver resection for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) showed significantly better overall survival and protection of liver function but no significant difference in the cumulative incidences of HCC recurrence.

Major finding: Although patients receiving TDF vs. ETV showed no significant difference in recurrence-free survival after propensity-score matching (hazard ratio [HR] 0.91; P = .45), they had significantly better overall survival (HR 0.37; P = .002) and liver function (P = .001).

Study details: This retrospective, single-center study reviewed data on 1,173 adult patients with HBV-related HCC who had undergone liver resection and were initially treated with either TDF or ETV for chronic HBV infection.

Disclosures: The study was funded by Sun Yat-sen University Cancer Center physician-scientist funding and National Science and Technology Major Project of China. The authors reported having no conflict of interests.

Source: Wang XH et al. Tenofovir vs. entecavir on prognosis of hepatitis B virus-related hepatocellular carcinoma after curative resection. J Gastroenterol. 2022;57:185-198 (Feb 13). Doi: 10.1007/s00535-022-01855-x

Key clinical point: Patients receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) after curative liver resection for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) showed significantly better overall survival and protection of liver function but no significant difference in the cumulative incidences of HCC recurrence.

Major finding: Although patients receiving TDF vs. ETV showed no significant difference in recurrence-free survival after propensity-score matching (hazard ratio [HR] 0.91; P = .45), they had significantly better overall survival (HR 0.37; P = .002) and liver function (P = .001).

Study details: This retrospective, single-center study reviewed data on 1,173 adult patients with HBV-related HCC who had undergone liver resection and were initially treated with either TDF or ETV for chronic HBV infection.

Disclosures: The study was funded by Sun Yat-sen University Cancer Center physician-scientist funding and National Science and Technology Major Project of China. The authors reported having no conflict of interests.

Source: Wang XH et al. Tenofovir vs. entecavir on prognosis of hepatitis B virus-related hepatocellular carcinoma after curative resection. J Gastroenterol. 2022;57:185-198 (Feb 13). Doi: 10.1007/s00535-022-01855-x

Key clinical point: Patients receiving tenofovir disoproxil fumarate (TDF) vs. entecavir (ETV) after curative liver resection for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) showed significantly better overall survival and protection of liver function but no significant difference in the cumulative incidences of HCC recurrence.

Major finding: Although patients receiving TDF vs. ETV showed no significant difference in recurrence-free survival after propensity-score matching (hazard ratio [HR] 0.91; P = .45), they had significantly better overall survival (HR 0.37; P = .002) and liver function (P = .001).

Study details: This retrospective, single-center study reviewed data on 1,173 adult patients with HBV-related HCC who had undergone liver resection and were initially treated with either TDF or ETV for chronic HBV infection.

Disclosures: The study was funded by Sun Yat-sen University Cancer Center physician-scientist funding and National Science and Technology Major Project of China. The authors reported having no conflict of interests.

Source: Wang XH et al. Tenofovir vs. entecavir on prognosis of hepatitis B virus-related hepatocellular carcinoma after curative resection. J Gastroenterol. 2022;57:185-198 (Feb 13). Doi: 10.1007/s00535-022-01855-x

Key clinical point: The risk for hepatocellular carcinoma (HCC) varies with underlying etiologies, with active hepatitis C virus (HCV) cirrhosis posing the highest and alcoholic or nonalcoholic fatty liver disease (NAFLD) cirrhosis posing the lowest risk of developing HCC.

Major finding: Patients with active HCV (3.36%) showed the highest annual HCC incidence rate, followed by those with cured HCV (1.71%), alcoholic liver disease (1.32%), and NAFLD cirrhosis (1.24%). Patients with active HCV vs. NAFLD were at a 2.1-fold higher risk for HCC (adjusted hazard ratio 2.16; 95% CI, 1.16-4.04).

Study details: This multicenter, prospective cohort study analyzed data from two multiethnic cohorts enrolling a total of 2,733 patients with cirrhosis.

Disclosures: The study received financial support from the National Cancer Institute; Cancer Prevention & Research Institute of Texas grant; and Center for Gastrointestinal Development, Infection, and Injury. No conflicts of interest were reported.

Source: Kanwal F et al. Risk factors for hepatocellular cancer in contemporary cohorts of patients with cirrhosis. Hepatology. 2022 (Mar 1). Doi: 10.1002/hep.32434

Key clinical point: The risk for hepatocellular carcinoma (HCC) varies with underlying etiologies, with active hepatitis C virus (HCV) cirrhosis posing the highest and alcoholic or nonalcoholic fatty liver disease (NAFLD) cirrhosis posing the lowest risk of developing HCC.

Major finding: Patients with active HCV (3.36%) showed the highest annual HCC incidence rate, followed by those with cured HCV (1.71%), alcoholic liver disease (1.32%), and NAFLD cirrhosis (1.24%). Patients with active HCV vs. NAFLD were at a 2.1-fold higher risk for HCC (adjusted hazard ratio 2.16; 95% CI, 1.16-4.04).

Study details: This multicenter, prospective cohort study analyzed data from two multiethnic cohorts enrolling a total of 2,733 patients with cirrhosis.

Disclosures: The study received financial support from the National Cancer Institute; Cancer Prevention & Research Institute of Texas grant; and Center for Gastrointestinal Development, Infection, and Injury. No conflicts of interest were reported.

Source: Kanwal F et al. Risk factors for hepatocellular cancer in contemporary cohorts of patients with cirrhosis. Hepatology. 2022 (Mar 1). Doi: 10.1002/hep.32434

Key clinical point: The risk for hepatocellular carcinoma (HCC) varies with underlying etiologies, with active hepatitis C virus (HCV) cirrhosis posing the highest and alcoholic or nonalcoholic fatty liver disease (NAFLD) cirrhosis posing the lowest risk of developing HCC.

Major finding: Patients with active HCV (3.36%) showed the highest annual HCC incidence rate, followed by those with cured HCV (1.71%), alcoholic liver disease (1.32%), and NAFLD cirrhosis (1.24%). Patients with active HCV vs. NAFLD were at a 2.1-fold higher risk for HCC (adjusted hazard ratio 2.16; 95% CI, 1.16-4.04).

Study details: This multicenter, prospective cohort study analyzed data from two multiethnic cohorts enrolling a total of 2,733 patients with cirrhosis.

Disclosures: The study received financial support from the National Cancer Institute; Cancer Prevention & Research Institute of Texas grant; and Center for Gastrointestinal Development, Infection, and Injury. No conflicts of interest were reported.

Source: Kanwal F et al. Risk factors for hepatocellular cancer in contemporary cohorts of patients with cirrhosis. Hepatology. 2022 (Mar 1). Doi: 10.1002/hep.32434