【Lancet】The cure rate is nearly 50%! The survival rate is over 90%! A team from the University of Hong Kong has discovered a new strategy for the treatment of locally advanced liver cancer

This article is the original of Translational Medicine Network, please indicate the source for reprinting

Written by Sophia

At present, the synergy between locoregional therapy and immune checkpoint inhibitors has not been studied as a translational therapy
for unresectable hepatocellular carcinoma.

Recently, the pioneering Phase II clinical study of triple mode therapy (START-FIT) conducted by the Department of Surgery and Clinical Oncology, School of Clinical Medicine, The University of Hong Kong, Li Ka Shing School of Medicine, found that nearly 50% of patients with inoperable locally advanced liver cancer can be cured
by this innovative method.
This revolutionary result has been published in The Lancet Gastroenterology and Hepatology
.

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Research background

 01 

Liver cancer is the sixth most common cancer worldwide, with more than 900,000 new cases each year, and the third leading cause
of cancer-related death.
According to the Hong Kong Cancer Database, there are about 1,800 new cases
every year.
However, only 30% of people are eligible for radical treatment, while the rest can only be treated
with non-curative methods due to reasons such as large tumor size or vascular invasion.

The team focused on these 70 percent of inoperable cases and developed a new treatment modality to improve their chances
of healing.

Research progress

 02 

From March 2019 to January 2021, a total of 33 patients with tumor diameters ranging
from 5 to 17.
5 cm were screened and enrolled.
64% of patients had tumors with severe vascular infiltration, making them unable to undergo radical surgery
.

The team developed a new method called "reduce and remove" — triple mode therapy (START-FIT)
for these 33 patients.
Patients will receive transarterial chemoembolization (TACE) to control the local tumor on day 1, then stereotactic body radiation therapy (SBRT) on day 28, followed by immunotherapy
14 days after SBRT and every 2 weeks thereafter.
In short, this triple model approach is to reduce tumor status to a level suitable for surgical intervention to achieve cure
for liver cancer.

After receiving this novel triple mode of treatment, 55% (18 patients) were candidates for radical surgery, of which 4 patients (12%) underwent surgery and 14 patients (42%) had complete necrotic tumors, which they opted for close monitoring
by regular scans.
After up to 2.
5 years of follow-up, these patients had a two-year survival rate of more than 90% and only mild side effects
throughout treatment.

The advantages of this method are minimally invasive, short hospital stay, and relatively high
safety.
The most common side effects include transient liver dysfunction after TACE, and a small number of patients may experience some mild immune-related reactions
.

Research significance

 03 

This innovative treatment strategy provides an opportunity for patients who are not initially unsuitable for surgery to eventually undergo curative surgery with promising long-term results
.
This treatment strategy provides a clear treatment schedule
.
Most patients have a better understanding of the effects of treatment within six months of starting treatment and are able to make better plans
for themselves and their families.

Now, the team looks forward to expanding treatment coverage to more patients, particularly those with poor liver function, to help reduce tumor status, thereby increasing the chances of
meeting liver transplant criteria in the future.
" Researchers are also looking for ways to improve the efficacy of immunotherapy, from single to dual agents, to provide stronger and more reliable treatment outcomes
.

Resources:

https://medicalxpress.
com/news/2023-01-treatment-strategy-locally-advanced-liver.
html

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Note: This article is intended to introduce the progress of medical research and cannot be used as a reference
for treatment options.
If you need health guidance, please go to a regular hospital
.

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