Severance unveils 3-step treatment program to treat advanced liver cancer

Lee Han-soo  Published 2020.07.14  17:48  Updated 2020.07.14 17:48


Researchers at Severance Hospital said that they could increase the survival rate of patients with advanced liver cancer who could not receive treatment, by conducting radiotherapy and administering anti-cancer drugs at the same time.

A Severance Hospital research team has developed a 3-stage therapy that can treat advanced liver cancer more effectively. From left are Professors Kim Beom-kyung, Kim Do-young and Seong Jin-sil. (Severance)

When adding targeted treatment after a combination of radiation and anti-cancer treatment, more than half of the patients had their cancer cells reduce by 30 percent or more, the hospital said.

Currently, the standard treatment for advanced liver cancer is not fundamental, but a palliative treatment aimed at improving symptoms. In the actual medical field, hospitals mainly recommend using sorafenib, which is a targeted therapy, to patients. However, the drug increases the survival period of the patients by only two to three months.

Such a short survival period extension is due to the nature of the targeted therapeutic agent as it is difficult to induce the tumor to decrease in response to the therapeutic agent. In the case of sorafenib, the tumor size diminishes by only about 3 percent.

If the tumor does not shrink, treatment aimed at curing is impossible, and it isn't easy to increase the survival time further. However, when the tumor size is reduced, the tumor can be surgically excised, while patients can expect long-term survival through liver transplantation.

To confirm the therapeutic effect of the radiation-hepatic arterial chemotherapy (LD-CCRT), the research team of Professors Kim Beom-kyung, Kim Do-young and Seong Jin-sil at Yonsei Cancer Hospital within the Severance Hospital conducted a clinical trial in 47 patients with advanced liver cancer.

The participants consisted of patients with large tumor size and hepatic portal vein, or patients with high tumor markers, were considered to have a poor prognosis due to high cancer markers.

LD-CCRT combines hepatic artery chemotherapy with radiation therapy and enhances tumor reduction by increasing the radiation effect while suppressing metastasis in the liver.

Also, as hospitals inject the anti-cancer drugs directly into the liver artery, it is possible to reduce the likelihood of systemic toxic reactions such as nausea, vomiting, cold sweat, dizziness, and difficulty breathing.

As a result, the team confirmed that the treatment reduced the tumor by 30 percent or more in 44.7 percent of the patients after a month after starting treatment with LD-CCRT.

Subsequently, 34 of the 47 patients received maintenance therapy with the targeted therapy sorafenib. Afterward, the team confirmed that 53.2 percent of patients decreased tumor size by more than 30 percent, and 8.5 percent improved further.

Notably, nine out of 47 patients dropped down to a lower stage of liver cancer after treatment, allowing liver resection or liver transplantation to cure them completely.

The average survival period of 47 patients in the group was 24.6 months, which was much longer than the average survival period of patients with advanced liver cancer of about 12 months.

The participants' side effects included diarrhea (36.2 percent), and hand and foot swelling after chemotherapy (34 percent).

"We have had excellent treatment results that more than double the survival of patients with progressive liver cancer," Professor Kim Beom-kyung said. "While sorafenib monotherapy reported a tumor reduction rate of about only 3 percent, 53.2 percent of patients received maintenance therapy with sorafenib after receiving radiation-hepatic arterial chemotherapy saw their tumor size reduce by more than 30 percent."

The research shows that this method is an effective and safe treatment to achieve excellent survival in patients with advanced liver cancer, Kim added.

The results of the research were published in the International Journal of Radiation Oncology, Biology, Physics.

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