Liver

Published by Andy LoCascio at July 6, 2018

Liver Cancer

Liver Cancer: Warning signs and questions to ask your physician.

Common Symptoms Of Liver Cancer:

Unexpected weight loss
Loss of appetite
Upper abdominal pain and abdominal swelling
Nausea, Vomiting, and Fatigue
Jaundice
White, chalky stools

Questions To Ask Your Doctor:

What kind of liver cancer do I have?
What stage is my cancer, and what does this mean?
How well is my liver working?
Before deciding on treatment, what other tests do I need?

November, 2022 Regorafenib Plus Ipilimumab and Nivolumab Shows Intriguing Activity in MSS mCRC
https://www.onclive.com/search?searchTerm=liver%20cancer

November, 2022 FDA Grants Orphan Drug Designation to OTX-2002 for Hepatocellular Carcinoma
https://www.onclive.com/view/fda-grants-orphan-drug-designation-to-otx-2002-for-hepatocellular-carcinoma

November, 20222 Treatment Options for Advanced HCC in the Second-Line and Beyond
https://www.onclive.com/view/treatment-options-for-advanced-hcc-in-the-second-line-and-beyond

November, 2022 Protein inhibitor could be new treatment for liver cancer
https://www.drugtargetreview.com/news/106285/protein-inhibitor-could-be-new-treatment-for-liver-cancer/

November, 2022 ASCO Small Study of Experimental Drug to Treat Liver Cancer Shows Evidence of Activity With Manageable Side Effects
https://ascopost.com/news/november-2022/small-study-of-experimental-drug-to-treat-liver-cancer-shows-evidence-of-activity-with-manageable-side-effects/

October, 2022 Real-World Use of Durvalumab + Tremelimumab in Advanced HCC
https://www.onclive.com/view/real-world-use-of-durvalumab-tremelimumab-in-advanced-hcc

October, 2022 FDA Approves Durvalumab/Tremelimumab in Unresectable HCC
https://www.onclive.com/view/fda-approves-durvalumab-tremelimumab-in-unresectable-hcc

October, 2022 FDA Approves New Immunotherapy for Advanced Liver Cancer
https://www.cancerhealth.com/article/fda-approves-new-immunotherapy-advanced-liver-cancer

Liver Cancer Overview

The liver is the organ in the body that is essential for the digestion of food. It filters blood from the intestines, processes nutrients and removes toxins. It also helps maintain the proper blood sugar levels in the body and produces some of the body’s blood clotting factors.

Liver cancer is the growth and spread of unhealthy cells in the liver. The most common form (80%) of liver cancer is called Hepatocellular Carcinoma (HCC). It begins in the hepatocytes, the main type of liver cell. HCC can have different growth patterns. The most common pattern in the United States is a tentacle-like growth through the liver, although some start as a single tumor that spreads to other parts of the liver.

Other subtypes of primary liver cancer:

Bile duct cancer (cholangiocarcinoma), which accounts for10-20% of liver cancer cases, starts in the small tubes that carry the bile made in the liver to the gallbladder, and in the bile ducts that carry bile from the gallbladder to the intestines.

Angiosarcoma and Hemangiosarcomas, which account for 1% of liver cancer patients, are fast growing cancers that originate in the blood vessels of the liver.

It is common for other types of cancers such as colon, stomach, pancreatic, breast or lung cancer to metastasize to the liver. This is not considered primary liver cancer and these liver tumors are treated with regard to their point of origin in the body, not as primary liver cancer.

Treatment For Liver Cancer

Treatment options if the cancer has not spread and the rest of the liver is healthy are:

Transplant: replacement of the liver

Surgery: removal of the tumor from the liver (partial hepatectomy)

Other treatment options if transplant and surgery are not possible include:

Cryosurgery: Cryosurgery uses a metal probe to freeze and destroy cancer cells.

Radiofrequency Ablation uses a special probe to destroy cancer cells with heat.

Ethanol Injection: Ethanol alcohol is injected directly into the liver tumor to destroy cancer cells.

Chemotherapy or Chemoembolization: Chemotherapy drugs may be used to destroy cancer cells. In some cases, the chemotherapy can be directly injected into the liver tumor.

Radiation Therapy: Radiation uses high-energy X-rays to destroy cancer cells.

Targeted Therapies:

Anti-angiogenesis therapy: these treatments are focused on stopping angiogenesis, which is the process of making new blood vessels. The goal is to deprive the tumor of blood and nutrients in order to arrest tumor growth. The anti-angiogenesis drug Sorafenib (Nexavar) Sorafenib is one oral medication FDA approved for use in advance cases of hepatocellular carcinoma.Bevacizumab (Avastin®) is another anti blood vessel growth agent being studied for use against liver cancer.

Other targeted treatments that are in clinical studies include Menatetrenone, a drug that is chemically similar to Vitamin K, and linifanib, tivantinib, and brivanib, which work by slowing the growth of tumor blood vessels.

Another targeted therapy option may be Erlotinib (Tarceva®), which targets a protein called EGFR on cancer cells.

Virus therapy: Virus therapy works by exploiting a genetic mutation inside cancer cells that does not exist in normal cells. The mutation allows the virus to enter tumor cells and produce thousands of copies of itself.

Eventually, the cancer cells bursts, releasing the virus particles, which in turn will infect other cancer cells. One virus treatment for liver cancer is called JX-594, and uses an altered virus to stimulate the patients’ own immune response to destroy the liver cancer.

Clinical Trials for Liver Cancer

ClinicalTrials.gov: Carcinoma, Hepatocellular(National Institutes of Health)
http://clinicaltrials.gov/search/open/condition=%22Carcinoma,+Hepatocellular%22

ClinicalTrials.gov: Hepatoblastoma(National Institutes of Health)
http://clinicaltrials.gov/search/open/condition=%22Hepatoblastoma%22

ClinicalTrials.gov: Liver Neoplasms(National Institutes of Health)
http://clinicaltrials.gov/search/open/condition=%22Liver+Neoplasms%22
Liver Cancer Clinical Research Trials

Center for Information and Study on Clinical Research Participation (CISCRP). CISCRP offers an online clinical trials search engine at SearchClinicalTrials.org. In addition, they provide a toll-free number where patients can receive help locating a clinical trial.
www.SearchClinicalTreials.org

Centerwatch This site helps people connect with clinical trials by offering a list of institutional review board (IRB)-approved clinical trials.
www.centerwatch.com

ClinicalTrials.gov This database of publicly and privately supported clinical trials is maintained by the National Library of Medicine at the NIH.
www.clinicaltrials.gov

Coalition of Cancer Cooperative Groups This organization provides resources and information in order for patients to search for clinical trials.
www.cancertrialshelp.org

EmergingMed Navigator- This organization helps to identify clinical trial options that match a patient’s specific diagnosis, stage and treatment history. Clinical trial specialists can also provide telephone support to help connect eligible patients with IRB-approved study sites that are enrolling new participants.
www.emergingmed.com

WHO International Clinical Trials Registry Platform Search Portal The World Health Organization (WHO) coordinates health matters within the United Nations. This database allows people to search clinical trial registration information from many countries’ registries.
http://www.who.int/ictrp/en/

Additional Educational Resources for Liver Cancer

Cancer.net
http://www.cancer.net/cancer-types/liver-cancer

WebMD
http://www.webmd.com/cancer/understanding-liver-cancer-basic-information

On Health.com
http://www.onhealth.com/liver_cancer/article.htm

Adult Primary Liver Cancer (PDQ): Treatment(National Cancer Institute) Also available in Spanish
http://www.cancer.gov/cancertopics/pdq/treatment/adult-primary-liver/patient/

National Cancer Institute
http://www.cancer.gov/cancertopics/wyntk/liver

Cryosurgery in Cancer Treatment: Questions and Answers(National Cancer Institute)

Cryotherapy(Radiological Society of North America, American College of Radiology) Also available in Spanish

How Is Liver Cancer Treated?(American Cancer Society)

Interventional Radiology Treatments for Liver Cancer (Society of Interventional Radiology)

Radiation Therapy (CanLiv)

Radiofrequency Ablation of Liver Tumors (Radiological Society of North America, American College of Radiology)