Hepatocellular Carcinoma

Key clinical point: The use of active surveillance caused no decline in quality of life for men with low-risk prostate cancer.

Major finding: Quality of life scores did not change significantly when averaged over 7 years of active surveillance; the physical function subdomain score showed clinical importance but remained about reference values.

Study details: The data come from 348 prostate cancer patients enrolled in the PRIAS trial, a prospective, longitudinal study of men with low-risk prostate cancer.

Disclosures: The study was supported in part by the Finnish Cancer Foundation, and the Jane and Aatos Erkko Foundation. The researchers had no financial conflicts to disclose.

Source: Lokman U et al. Eur Urol Focus. 2021 Jul 6. doi: 10.1016/j.euf.2021.06.008.

Key clinical point: The use of active surveillance caused no decline in quality of life for men with low-risk prostate cancer.

Major finding: Quality of life scores did not change significantly when averaged over 7 years of active surveillance; the physical function subdomain score showed clinical importance but remained about reference values.

Study details: The data come from 348 prostate cancer patients enrolled in the PRIAS trial, a prospective, longitudinal study of men with low-risk prostate cancer.

Disclosures: The study was supported in part by the Finnish Cancer Foundation, and the Jane and Aatos Erkko Foundation. The researchers had no financial conflicts to disclose.

Source: Lokman U et al. Eur Urol Focus. 2021 Jul 6. doi: 10.1016/j.euf.2021.06.008.

Key clinical point: The use of active surveillance caused no decline in quality of life for men with low-risk prostate cancer.

Major finding: Quality of life scores did not change significantly when averaged over 7 years of active surveillance; the physical function subdomain score showed clinical importance but remained about reference values.

Study details: The data come from 348 prostate cancer patients enrolled in the PRIAS trial, a prospective, longitudinal study of men with low-risk prostate cancer.

Disclosures: The study was supported in part by the Finnish Cancer Foundation, and the Jane and Aatos Erkko Foundation. The researchers had no financial conflicts to disclose.

Source: Lokman U et al. Eur Urol Focus. 2021 Jul 6. doi: 10.1016/j.euf.2021.06.008.

Key clinical point: The platelet-to-lymphocyte ratio (PLR) was not significantly different among men with benign disease, clinically insignificant prostate cancer, and clinically significant prostate cancer prior to biopsy.

Major finding: Pre-biopsy PLR did not predict prostate cancer status at the time of a biopsy was in multivariate analysis, although PLR was higher in subset of patients with serum PSA levels less than 10 ng/mL, with clinically significant cancer.

Study details: The data come from a cohort study of 1652 men with elevated PSA levels who underwent standard 12-core transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to determine prostate cancer status.

Disclosures: The study was supported in part by the Korea Medical Device Development Fund. The researchers had no financial conflicts to disclose.

Source: Lee JW et al. Sci Rep. 2021 Jul 9. doi: 10.1038/s41598-021-93637-3.

Key clinical point: The platelet-to-lymphocyte ratio (PLR) was not significantly different among men with benign disease, clinically insignificant prostate cancer, and clinically significant prostate cancer prior to biopsy.

Major finding: Pre-biopsy PLR did not predict prostate cancer status at the time of a biopsy was in multivariate analysis, although PLR was higher in subset of patients with serum PSA levels less than 10 ng/mL, with clinically significant cancer.

Study details: The data come from a cohort study of 1652 men with elevated PSA levels who underwent standard 12-core transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to determine prostate cancer status.

Disclosures: The study was supported in part by the Korea Medical Device Development Fund. The researchers had no financial conflicts to disclose.

Source: Lee JW et al. Sci Rep. 2021 Jul 9. doi: 10.1038/s41598-021-93637-3.

Key clinical point: The platelet-to-lymphocyte ratio (PLR) was not significantly different among men with benign disease, clinically insignificant prostate cancer, and clinically significant prostate cancer prior to biopsy.

Major finding: Pre-biopsy PLR did not predict prostate cancer status at the time of a biopsy was in multivariate analysis, although PLR was higher in subset of patients with serum PSA levels less than 10 ng/mL, with clinically significant cancer.

Study details: The data come from a cohort study of 1652 men with elevated PSA levels who underwent standard 12-core transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to determine prostate cancer status.

Disclosures: The study was supported in part by the Korea Medical Device Development Fund. The researchers had no financial conflicts to disclose.

Source: Lee JW et al. Sci Rep. 2021 Jul 9. doi: 10.1038/s41598-021-93637-3.

Key clinical point: Treatment with radiation therapy is safe and effective for men with prostate cancer and underlying inflammatory bowel disease, with no biochemical relapses during an early follow-up period. 

Major finding: With a median time of 22 months to any GI toxicity, one IBD patient experienced a high-grade toxicity (grade 3 proctitis) and 3 patients reported hemorrhoidal flares as the most common low-grade toxicity.

Study details: The data come from an institutional database of 4245 men who underwent stereotactic body radiation therapy for prostate cancer, including 31 patients with underlying inflammatory bowel disease.

Disclosures: The study was supported in part by a grant from Accuray. The researchers had no other financial conflicts to disclose.

Source: Lischalk JW et al. Radiat Oncol. 2021 Jul 9 doi: 10.1186/s13014-021-01850-1.

Key clinical point: Treatment with radiation therapy is safe and effective for men with prostate cancer and underlying inflammatory bowel disease, with no biochemical relapses during an early follow-up period. 

Major finding: With a median time of 22 months to any GI toxicity, one IBD patient experienced a high-grade toxicity (grade 3 proctitis) and 3 patients reported hemorrhoidal flares as the most common low-grade toxicity.

Study details: The data come from an institutional database of 4245 men who underwent stereotactic body radiation therapy for prostate cancer, including 31 patients with underlying inflammatory bowel disease.

Disclosures: The study was supported in part by a grant from Accuray. The researchers had no other financial conflicts to disclose.

Source: Lischalk JW et al. Radiat Oncol. 2021 Jul 9 doi: 10.1186/s13014-021-01850-1.

Key clinical point: Treatment with radiation therapy is safe and effective for men with prostate cancer and underlying inflammatory bowel disease, with no biochemical relapses during an early follow-up period. 

Major finding: With a median time of 22 months to any GI toxicity, one IBD patient experienced a high-grade toxicity (grade 3 proctitis) and 3 patients reported hemorrhoidal flares as the most common low-grade toxicity.

Study details: The data come from an institutional database of 4245 men who underwent stereotactic body radiation therapy for prostate cancer, including 31 patients with underlying inflammatory bowel disease.

Disclosures: The study was supported in part by a grant from Accuray. The researchers had no other financial conflicts to disclose.

Source: Lischalk JW et al. Radiat Oncol. 2021 Jul 9 doi: 10.1186/s13014-021-01850-1.

For patients with hepatocellular carcinoma (HCC) and liver-dominant disease, liver-directed therapy is frequently used as the initial attempt to control this malignancy. This month we will review several journal articles that address different forms of localized HCC management.

Ding W et al. analyzed 401 patients with early HCC who were treated in one center, either with microwave ablation (MWA, n=240) or robotic-assisted hepatectomy (RH, n=161). Following propensity-score matching (PSM) and inverse probability of treatment weight analysis, the authors found that both treatments can achieve safe, comparable therapeutic effects. The 3-year recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) of MWA group and RH group were 52.2% vs 65.8%, 91.5% vs 91.3% and 91.5% vs 91.3%, respectively. OS and CSS were comparable (P = 0.44 and 0.96), while RFS of patients treated with MWA was slightly lower but not significantly so (P = 0.097). The authors concluded that both minimally-invasive approaches are effective in the treatment of early HCC. MWA was less invasive, while RH had better accuracy and caused less damage to the liver parenchyma.

Transarterial therapies are frequently withheld in patients who have major vascular invasion (HCC-MVI), and patients usually receive palliative systemic therapy instead. Kwee et al. examined the National Cancer Database (NCDB) data to comparatively evaluate overall survival (OS) between transarterial radioembolization (TARE) and systemic therapy in hepatocellular carcinoma (HCC) with major vascular invasion (HCC-MVI). OS was compared by propensity-score matched Cox regression and landmark analysis in 1514 patients with HCC-MVI who were treated between 2010 and 2015. Propensity-score matched and landmark-time adjusted analysis associated TARE with a median OS 7.1 months (95% CI 5.0 to 10.5) vs 4.9 months (95% CI 3.9 to 6.5) for patients treated with systemic therapy only, HR 0.74 (95% CI 0.60 to 0.91, P = 0.005). The authors were encouraged by these results, and suggested that additional prospective studies using TARE as treatment of HCC-MVI should be undertaken.

The SARAH trial (Vilgrain et al., Lancet Oncology 2017) compared the efficacy and safety of sorafenib to that of selective internal radiotherapy (SIRT) with yttrium-90 (90Y) resin microspheres (also termed TARE, transarterial radioembolization) in patients with hepatocellular carcinoma. The final conclusion was that overall survival did not significantly differ between the two groups. Pereira et al. published this ancillary study of the SARAH trial that compares health-related quality of life (HRQoL) between the two groups. HRQoL was preserved longer with TARE than with sorafenib in locally advanced HCC. The median time to deterioration for the global health status was 3.9 months (95% confidence interval [CI] 3.7–4.3) in the TARE group, vs 2.6 months (95% CI 2.0–3.0) in the sorafenib group. The authors concluded that the differences in HRQoL should inform decisions when recommending initial treatment of patients with HCC, though it does not take into account recently developed advancements in systemic therapy including immunotherapy.

For patients with hepatocellular carcinoma (HCC) and liver-dominant disease, liver-directed therapy is frequently used as the initial attempt to control this malignancy. This month we will review several journal articles that address different forms of localized HCC management.

Ding W et al. analyzed 401 patients with early HCC who were treated in one center, either with microwave ablation (MWA, n=240) or robotic-assisted hepatectomy (RH, n=161). Following propensity-score matching (PSM) and inverse probability of treatment weight analysis, the authors found that both treatments can achieve safe, comparable therapeutic effects. The 3-year recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) of MWA group and RH group were 52.2% vs 65.8%, 91.5% vs 91.3% and 91.5% vs 91.3%, respectively. OS and CSS were comparable (P = 0.44 and 0.96), while RFS of patients treated with MWA was slightly lower but not significantly so (P = 0.097). The authors concluded that both minimally-invasive approaches are effective in the treatment of early HCC. MWA was less invasive, while RH had better accuracy and caused less damage to the liver parenchyma.

Transarterial therapies are frequently withheld in patients who have major vascular invasion (HCC-MVI), and patients usually receive palliative systemic therapy instead. Kwee et al. examined the National Cancer Database (NCDB) data to comparatively evaluate overall survival (OS) between transarterial radioembolization (TARE) and systemic therapy in hepatocellular carcinoma (HCC) with major vascular invasion (HCC-MVI). OS was compared by propensity-score matched Cox regression and landmark analysis in 1514 patients with HCC-MVI who were treated between 2010 and 2015. Propensity-score matched and landmark-time adjusted analysis associated TARE with a median OS 7.1 months (95% CI 5.0 to 10.5) vs 4.9 months (95% CI 3.9 to 6.5) for patients treated with systemic therapy only, HR 0.74 (95% CI 0.60 to 0.91, P = 0.005). The authors were encouraged by these results, and suggested that additional prospective studies using TARE as treatment of HCC-MVI should be undertaken.

The SARAH trial (Vilgrain et al., Lancet Oncology 2017) compared the efficacy and safety of sorafenib to that of selective internal radiotherapy (SIRT) with yttrium-90 (90Y) resin microspheres (also termed TARE, transarterial radioembolization) in patients with hepatocellular carcinoma. The final conclusion was that overall survival did not significantly differ between the two groups. Pereira et al. published this ancillary study of the SARAH trial that compares health-related quality of life (HRQoL) between the two groups. HRQoL was preserved longer with TARE than with sorafenib in locally advanced HCC. The median time to deterioration for the global health status was 3.9 months (95% confidence interval [CI] 3.7–4.3) in the TARE group, vs 2.6 months (95% CI 2.0–3.0) in the sorafenib group. The authors concluded that the differences in HRQoL should inform decisions when recommending initial treatment of patients with HCC, though it does not take into account recently developed advancements in systemic therapy including immunotherapy.

For patients with hepatocellular carcinoma (HCC) and liver-dominant disease, liver-directed therapy is frequently used as the initial attempt to control this malignancy. This month we will review several journal articles that address different forms of localized HCC management.

Ding W et al. analyzed 401 patients with early HCC who were treated in one center, either with microwave ablation (MWA, n=240) or robotic-assisted hepatectomy (RH, n=161). Following propensity-score matching (PSM) and inverse probability of treatment weight analysis, the authors found that both treatments can achieve safe, comparable therapeutic effects. The 3-year recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) of MWA group and RH group were 52.2% vs 65.8%, 91.5% vs 91.3% and 91.5% vs 91.3%, respectively. OS and CSS were comparable (P = 0.44 and 0.96), while RFS of patients treated with MWA was slightly lower but not significantly so (P = 0.097). The authors concluded that both minimally-invasive approaches are effective in the treatment of early HCC. MWA was less invasive, while RH had better accuracy and caused less damage to the liver parenchyma.

Transarterial therapies are frequently withheld in patients who have major vascular invasion (HCC-MVI), and patients usually receive palliative systemic therapy instead. Kwee et al. examined the National Cancer Database (NCDB) data to comparatively evaluate overall survival (OS) between transarterial radioembolization (TARE) and systemic therapy in hepatocellular carcinoma (HCC) with major vascular invasion (HCC-MVI). OS was compared by propensity-score matched Cox regression and landmark analysis in 1514 patients with HCC-MVI who were treated between 2010 and 2015. Propensity-score matched and landmark-time adjusted analysis associated TARE with a median OS 7.1 months (95% CI 5.0 to 10.5) vs 4.9 months (95% CI 3.9 to 6.5) for patients treated with systemic therapy only, HR 0.74 (95% CI 0.60 to 0.91, P = 0.005). The authors were encouraged by these results, and suggested that additional prospective studies using TARE as treatment of HCC-MVI should be undertaken.

The SARAH trial (Vilgrain et al., Lancet Oncology 2017) compared the efficacy and safety of sorafenib to that of selective internal radiotherapy (SIRT) with yttrium-90 (90Y) resin microspheres (also termed TARE, transarterial radioembolization) in patients with hepatocellular carcinoma. The final conclusion was that overall survival did not significantly differ between the two groups. Pereira et al. published this ancillary study of the SARAH trial that compares health-related quality of life (HRQoL) between the two groups. HRQoL was preserved longer with TARE than with sorafenib in locally advanced HCC. The median time to deterioration for the global health status was 3.9 months (95% confidence interval [CI] 3.7–4.3) in the TARE group, vs 2.6 months (95% CI 2.0–3.0) in the sorafenib group. The authors concluded that the differences in HRQoL should inform decisions when recommending initial treatment of patients with HCC, though it does not take into account recently developed advancements in systemic therapy including immunotherapy.

Key clinical point: HCC patients with hepatitis B/C coinfection had worse long-term outcomes after liver resection than patients with hepatitis B infection only.

Major finding: In the propensity score matched cohort, 3-year and 5-year recurrence-free survival rates were significantly worse in HCC patients with hepatitis B/C coinfection (48.3% and 38.9%) than in those with hepatitis B only (61.8% and 49.2%, P = 0.037).

Study details: The data come from a multicenter, observational study of 2,467 adults with HCC who underwent curative-intent liver resection. Of these, 93 also had concurrent hepatitis B/C coinfection and 2,374 had hepatitis B. Propensity score matching paired patients with hepatitis B and hepatitis B/C co-infection.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Jia H-D et al. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.EP-44.

Key clinical point: HCC patients with hepatitis B/C coinfection had worse long-term outcomes after liver resection than patients with hepatitis B infection only.

Major finding: In the propensity score matched cohort, 3-year and 5-year recurrence-free survival rates were significantly worse in HCC patients with hepatitis B/C coinfection (48.3% and 38.9%) than in those with hepatitis B only (61.8% and 49.2%, P = 0.037).

Study details: The data come from a multicenter, observational study of 2,467 adults with HCC who underwent curative-intent liver resection. Of these, 93 also had concurrent hepatitis B/C coinfection and 2,374 had hepatitis B. Propensity score matching paired patients with hepatitis B and hepatitis B/C co-infection.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Jia H-D et al. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.EP-44.

Key clinical point: HCC patients with hepatitis B/C coinfection had worse long-term outcomes after liver resection than patients with hepatitis B infection only.

Major finding: In the propensity score matched cohort, 3-year and 5-year recurrence-free survival rates were significantly worse in HCC patients with hepatitis B/C coinfection (48.3% and 38.9%) than in those with hepatitis B only (61.8% and 49.2%, P = 0.037).

Study details: The data come from a multicenter, observational study of 2,467 adults with HCC who underwent curative-intent liver resection. Of these, 93 also had concurrent hepatitis B/C coinfection and 2,374 had hepatitis B. Propensity score matching paired patients with hepatitis B and hepatitis B/C co-infection.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Jia H-D et al. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.EP-44.

Key clinical point: Perioperative outcomes were significantly better in recurrent HCC patients who underwent laparoscopic repeat liver resection (LRLR) compared to those who had open laparoscopic repeat liver resection (ORLR).

Major finding: Patients with recurrent hepatocellular carcinoma who underwent LRLR had shorter operative times (mean 159.74 minutes vs 250.19 minutes), less intraoperative blood loss (mean 185.65 mL vs 385.56 mL), lower morbidity (8.6% vs 62.9%), and shorter hospital stays (mean 5.83 days vs 9.26 days) compared to patients who had ORLR.

Study details: The data come from a review of 50 cases of repeat liver resections performed at a single center between January 2009 and November 2020; 23 patients had laparoscopic procedures and 27 had open procedures.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Tagaytay TG et al. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.LV-PP-4-1.

Key clinical point: Perioperative outcomes were significantly better in recurrent HCC patients who underwent laparoscopic repeat liver resection (LRLR) compared to those who had open laparoscopic repeat liver resection (ORLR).

Major finding: Patients with recurrent hepatocellular carcinoma who underwent LRLR had shorter operative times (mean 159.74 minutes vs 250.19 minutes), less intraoperative blood loss (mean 185.65 mL vs 385.56 mL), lower morbidity (8.6% vs 62.9%), and shorter hospital stays (mean 5.83 days vs 9.26 days) compared to patients who had ORLR.

Study details: The data come from a review of 50 cases of repeat liver resections performed at a single center between January 2009 and November 2020; 23 patients had laparoscopic procedures and 27 had open procedures.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Tagaytay TG et al. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.LV-PP-4-1.

Key clinical point: Perioperative outcomes were significantly better in recurrent HCC patients who underwent laparoscopic repeat liver resection (LRLR) compared to those who had open laparoscopic repeat liver resection (ORLR).

Major finding: Patients with recurrent hepatocellular carcinoma who underwent LRLR had shorter operative times (mean 159.74 minutes vs 250.19 minutes), less intraoperative blood loss (mean 185.65 mL vs 385.56 mL), lower morbidity (8.6% vs 62.9%), and shorter hospital stays (mean 5.83 days vs 9.26 days) compared to patients who had ORLR.

Study details: The data come from a review of 50 cases of repeat liver resections performed at a single center between January 2009 and November 2020; 23 patients had laparoscopic procedures and 27 had open procedures.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Tagaytay TG et al. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.LV-PP-4-1.

Key clinical point: Overall survival at 3 and 5 years was significantly greater in HCC patients who underwent anatomical liver resection compared to those who had nonanatomical liver resection (hazard ratios 0.79 and 0.83, respectively).

Major finding: Patients who underwent anatomical liver resection showed significantly better recurrence-free survival at 1, 3, and 5 years compared to those who underwent nonanatomical liver resection (HR 0.79, 0.81, and 0.82, respectively); anatomical liver resection patients also showed improved recurrence-free survival in a subgroup analysis of tumors less than 5 cm in diameter.

Study details: The data come from a meta-analysis of 19 propensity score matching studies of hepatocellular carcinoma patients who underwent anatomical or nonanatomical liver resection.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Shin S and Kim T-S. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.EP-37.

Key clinical point: Overall survival at 3 and 5 years was significantly greater in HCC patients who underwent anatomical liver resection compared to those who had nonanatomical liver resection (hazard ratios 0.79 and 0.83, respectively).

Major finding: Patients who underwent anatomical liver resection showed significantly better recurrence-free survival at 1, 3, and 5 years compared to those who underwent nonanatomical liver resection (HR 0.79, 0.81, and 0.82, respectively); anatomical liver resection patients also showed improved recurrence-free survival in a subgroup analysis of tumors less than 5 cm in diameter.

Study details: The data come from a meta-analysis of 19 propensity score matching studies of hepatocellular carcinoma patients who underwent anatomical or nonanatomical liver resection.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Shin S and Kim T-S. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.EP-37.

Key clinical point: Overall survival at 3 and 5 years was significantly greater in HCC patients who underwent anatomical liver resection compared to those who had nonanatomical liver resection (hazard ratios 0.79 and 0.83, respectively).

Major finding: Patients who underwent anatomical liver resection showed significantly better recurrence-free survival at 1, 3, and 5 years compared to those who underwent nonanatomical liver resection (HR 0.79, 0.81, and 0.82, respectively); anatomical liver resection patients also showed improved recurrence-free survival in a subgroup analysis of tumors less than 5 cm in diameter.

Study details: The data come from a meta-analysis of 19 propensity score matching studies of hepatocellular carcinoma patients who underwent anatomical or nonanatomical liver resection.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Shin S and Kim T-S. Ann Hepatobiliary Pancreat Surg. 2021 Jun 30. doi: 10.14701/ahbps.EP-37.

Key clinical point: Hepatocellular carcinoma patients with PVTT who received lenvatinib had a significantly longer time to progression compared to those treated with sorafenib.

Major finding: The median time to progression was 4.7 months for HCC patients with PVTT who received lenvatinib, compared to 3.1 months for those treated with sorafenib (hazard ratio 0.55, P = .029). In addition, objective response rates were significantly higher in the lenvatinib group vs the sorafenib group (53.1% vs 25.0%).

Study details: The data come from an open-label, single-center, randomized trial of 64 adults with previous untreated hepatocellular carcinoma and portal vein tumor thrombus (PVTT). Patients received TACE plus lenvatinib or sorafenib.

Disclosures: The study was supported by the Beijing Municipal Hospital Management Center Young Talent Training program. The researchers had no financial conflicts to disclose.

Source: Ding X et al. Cancer. 2021 Jul 8. doi: 10.1002/cncr.33677. 

Key clinical point: Hepatocellular carcinoma patients with PVTT who received lenvatinib had a significantly longer time to progression compared to those treated with sorafenib.

Major finding: The median time to progression was 4.7 months for HCC patients with PVTT who received lenvatinib, compared to 3.1 months for those treated with sorafenib (hazard ratio 0.55, P = .029). In addition, objective response rates were significantly higher in the lenvatinib group vs the sorafenib group (53.1% vs 25.0%).

Study details: The data come from an open-label, single-center, randomized trial of 64 adults with previous untreated hepatocellular carcinoma and portal vein tumor thrombus (PVTT). Patients received TACE plus lenvatinib or sorafenib.

Disclosures: The study was supported by the Beijing Municipal Hospital Management Center Young Talent Training program. The researchers had no financial conflicts to disclose.

Source: Ding X et al. Cancer. 2021 Jul 8. doi: 10.1002/cncr.33677. 

Key clinical point: Hepatocellular carcinoma patients with PVTT who received lenvatinib had a significantly longer time to progression compared to those treated with sorafenib.

Major finding: The median time to progression was 4.7 months for HCC patients with PVTT who received lenvatinib, compared to 3.1 months for those treated with sorafenib (hazard ratio 0.55, P = .029). In addition, objective response rates were significantly higher in the lenvatinib group vs the sorafenib group (53.1% vs 25.0%).

Study details: The data come from an open-label, single-center, randomized trial of 64 adults with previous untreated hepatocellular carcinoma and portal vein tumor thrombus (PVTT). Patients received TACE plus lenvatinib or sorafenib.

Disclosures: The study was supported by the Beijing Municipal Hospital Management Center Young Talent Training program. The researchers had no financial conflicts to disclose.

Source: Ding X et al. Cancer. 2021 Jul 8. doi: 10.1002/cncr.33677. 

Key clinical point: Statin users had a consistent, significant, dose-dependent reduction in the risk of hepatocellular carcinoma in a nested case-control study. Aspirin users showed some reduction in risk, but it was not dose dependent.

Major finding: In the nested case-control study, both statin use, and aspirin use were significantly associated with reduced HCC risk (odds ratio 0.34 and 0.92, respectively), but only statins showed a dose-dependent risk reduction.

Study details: The data come from a nationwide, nested case-control study with a cohort of 538 135 treatment-naïve, non-cirrhotic adults with chronic hepatitis B. The participants were identified from data gathered between 2005 and 2015 through the National Health Insurance Service in Korea. From this group, 6,539 HCC cases were matched to 26,156 controls.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Choi W-M et al. Liver Int. 2021. doi: 10.1111/liv.15011. 

Key clinical point: Statin users had a consistent, significant, dose-dependent reduction in the risk of hepatocellular carcinoma in a nested case-control study. Aspirin users showed some reduction in risk, but it was not dose dependent.

Major finding: In the nested case-control study, both statin use, and aspirin use were significantly associated with reduced HCC risk (odds ratio 0.34 and 0.92, respectively), but only statins showed a dose-dependent risk reduction.

Study details: The data come from a nationwide, nested case-control study with a cohort of 538 135 treatment-naïve, non-cirrhotic adults with chronic hepatitis B. The participants were identified from data gathered between 2005 and 2015 through the National Health Insurance Service in Korea. From this group, 6,539 HCC cases were matched to 26,156 controls.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Choi W-M et al. Liver Int. 2021. doi: 10.1111/liv.15011. 

Key clinical point: Statin users had a consistent, significant, dose-dependent reduction in the risk of hepatocellular carcinoma in a nested case-control study. Aspirin users showed some reduction in risk, but it was not dose dependent.

Major finding: In the nested case-control study, both statin use, and aspirin use were significantly associated with reduced HCC risk (odds ratio 0.34 and 0.92, respectively), but only statins showed a dose-dependent risk reduction.

Study details: The data come from a nationwide, nested case-control study with a cohort of 538 135 treatment-naïve, non-cirrhotic adults with chronic hepatitis B. The participants were identified from data gathered between 2005 and 2015 through the National Health Insurance Service in Korea. From this group, 6,539 HCC cases were matched to 26,156 controls.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Choi W-M et al. Liver Int. 2021. doi: 10.1111/liv.15011. 

Key clinical point: Transarterial radioembolization (TARE) was associated with a significantly higher overall survival compared to systemic therapy in patients with hepatocellular carcinoma with major vascular invasion (HCC-MVI).

Major finding: In a propensity-score matched and landmark-time adjusted analysis, the median overall survival for HCC-MVI patients treated with TARE was 7.1 months, compared to 4.9 months for patients treated with systemic therapy. Target trial emulation of an additional 236 patients with HCC-MVI showed a similar advantage with TARE.

Study details: The data come from 1,514 patients with hepatocellular carcinoma with major vascular invasion (HCC-MVI) identified from the National Cancer Database for the period between 2010 and 2015.

Disclosures: The study was supported by the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Patient-Centered Outcomes Research Institute. The researchers had no financial conflicts to disclose.

Source: Kwee SA et al. J Vasc Interv Radiol. 2021 Jul 6. doi: 10.1016/j.jvir.2021.07.001.

Key clinical point: Transarterial radioembolization (TARE) was associated with a significantly higher overall survival compared to systemic therapy in patients with hepatocellular carcinoma with major vascular invasion (HCC-MVI).

Major finding: In a propensity-score matched and landmark-time adjusted analysis, the median overall survival for HCC-MVI patients treated with TARE was 7.1 months, compared to 4.9 months for patients treated with systemic therapy. Target trial emulation of an additional 236 patients with HCC-MVI showed a similar advantage with TARE.

Study details: The data come from 1,514 patients with hepatocellular carcinoma with major vascular invasion (HCC-MVI) identified from the National Cancer Database for the period between 2010 and 2015.

Disclosures: The study was supported by the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Patient-Centered Outcomes Research Institute. The researchers had no financial conflicts to disclose.

Source: Kwee SA et al. J Vasc Interv Radiol. 2021 Jul 6. doi: 10.1016/j.jvir.2021.07.001.

Key clinical point: Transarterial radioembolization (TARE) was associated with a significantly higher overall survival compared to systemic therapy in patients with hepatocellular carcinoma with major vascular invasion (HCC-MVI).

Major finding: In a propensity-score matched and landmark-time adjusted analysis, the median overall survival for HCC-MVI patients treated with TARE was 7.1 months, compared to 4.9 months for patients treated with systemic therapy. Target trial emulation of an additional 236 patients with HCC-MVI showed a similar advantage with TARE.

Study details: The data come from 1,514 patients with hepatocellular carcinoma with major vascular invasion (HCC-MVI) identified from the National Cancer Database for the period between 2010 and 2015.

Disclosures: The study was supported by the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Patient-Centered Outcomes Research Institute. The researchers had no financial conflicts to disclose.

Source: Kwee SA et al. J Vasc Interv Radiol. 2021 Jul 6. doi: 10.1016/j.jvir.2021.07.001.