Background No effective systemic therapy exists for patients with advanced hepatocellular carcinoma. A preliminary study suggested that sorafenib, an oral multikinase inhibitor of the vascular endothelial growth factor receptor, the platelet-derived growth factor receptor, and Raf may be effective in hepatocellular carcinoma. Methods In this multicenter, phase 3, double-blind, placebo-controlled trial, we randomly assigned 602 patients with advanced hepatocellular carcinoma who had not received previous systemic treatment to receive either sorafenib (at a dose of 400 mg twice daily) or placebo. Primary outcomes were overall survival and the time to symptomatic progression. Secondary outcomes included the time to radiologic progression and safety. Results At the second planned interim analysis, 321 deaths had occurred, and the study was stopped. Median overall survival was 10.7 months in the sorafenib group and 7.9 months in the placebo group (hazard ratio in the sorafenib group, 0.69; 95% confidence interval, 0.55 to 0.87; P<0.001). There was no significant difference between the two groups in the median time to symptomatic progression (4.1 months vs. 4.9 months, respectively, P=0.77). The median time to radiologic progression was 5.5 months in the sorafenib group and 2.8 months in the placebo group (P<0.001). Seven patients in the sorafenib group (2%) and two patients in the placebo group (1%) had a partial response; no patients had a complete response. Diarrhea, weight loss, hand-foot skin reaction, and hypophosphatemia were more frequent in the sorafenib group. Conclusions In patients with advanced hepatocellular carcinoma, median survival and the time to radiologic progression were nearly 3 months longer for patients treated with sorafenib than for those given placebo.

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Sorafenib in Advanced Hepatocellular Carcinoma

EASL-EORTC clinical practice guidelines : management of hepatocellular carcinoma

Since the publication of the American Association for the Study of Liver Diseases (AASLD) practice guidelines on the management of hepatocellular carcinoma (HCC) in 2005, new information has emerged that requires that the guidelines be updated. The full version of the new guidelines is available on the AASLD Web site at http://www.aasld.org/practiceguidelines/ Documents/Bookmarked%20Practice%20Guidelines/ HCCUpdate2010.pdf. Here, we briefly describe only new or changed recommendations.

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AASLD PRACTICE GUIDELINE Management of Hepatocellular Carcinoma: An Update

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.20933

Management of hepatocellular carcinoma.

Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL Conference

Proceedings: AACR 101st Annual Meeting 2010‐‐ Apr 17‐21, 2010; Washington, DC

Hepatocellular carcinoma (HCC) shows low responses to most conventional chemotherapies. To facilitate target identifications for novel therapeutic developments, we deployed gene expression profiling on 43 paired HCC tumors and adjacent non-tumoral liver. Coupled with ontology analysis, the major functional process suggested in the malignant transformation of HCC was microtubule-related cellular assembly. We further examined the potential use of microtubule targeting Taxane drugs, including Paclitaxel and Docetaxel, and compared findings to the results obtained from Doxorubicin, a common chemotherapeutic agent used in the treatment of a number of neoplasms. Recent studies showed that drug delivery by nanoparticles have enhanced efficacy with reduced side effects. In this regard, the nanoparticle albumin-bound (nab)-Paclitaxel was also examined. In a panel of HCC cell lines studied, a high sensitivity towards Taxane drugs was generally found, although the effect from nab-Paclitaxel was most profound. The nab-Paclitaxel showed an effective IC50 dose at 15-fold lower than Paclitaxel alone or the derivative analogue Docetaxel, and approx.450-fold less compared to Doxorubicin. Flow cytometric analysis confirmed a cell cycle blockade at the G2/M phase and increased apoptosis following treatment with nab-Paclitaxel. In-vivo animal study also showed that nab-Paclitaxel readily inhibited xenograft growth with less toxicity compared to other anti-microtubule drugs and Doxorubicin. Silencing of a major microtubule regulatory gene STMN1 suggested a distinct synergistic effect in the combined treatment with nab-Paclitaxel. Our findings in this study would suggest the microtubule organizations to represent a promising target for treatment developments in HCC.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4423.

Abstract 4423: Novel therapeutic potential in targeting the microtubules by nanoparticle albumin-bound paclitaxel in hepatocellular carcinoma

5608 Background: Brain metastasis (mets) from nasopharyngeal carcinoma (NPC) is a controversial entity. Only 2 cases had ever been reported and no cohort study performed. Methods: We reviewed the clinical follow-up of a cohort of 1124 NPC cases first seen in our institute from 1993 to 2000, and identified 3 cases with intracranial mets on follow-up. All 3 patients received whole brain radiation therapy (WBRT) for the brain mets. Results: Case #1: A 45-year-old man presented with Stage T1N2M0 disease in 1996. In 2001, disease recurred in the neck and was inoperable. Static disease was achieved with chemotherapy. 1 year later, he experienced vertigo. Contrast CT brain revealed enhancing cystic lesions in both cerebellums. Histology of the lesion revealed metastatic undifferentiated carcinoma, staining positive for Epstein-Barr virus-encoded RNA (EBER). He received WBRT and remained alive at the most recent follow-up, which was 1 year after the diagnosis of brain mets. Case #2: A 51-year-old man presented wi...

Intracranial metastasis from nasopharyngeal carcinoma: Report of three cases and review of literature

The present invention provides methods and compositions for treating hepatocellular carcinoma (HCC) by administering a composition comprising nanoparticles that comprise a taxane and an albumin. The invention also provides combination therapy methods of treating HCC comprising administering to an individual an effective amount of a composition comprising nanoparticles that comprise a taxane and an albumin and another agent, such as an agent that inhibits microtubule disassembly.

Use of nanoparticles comprising a taxane and albumin in the treatment of hepatocellular carcinoma

e22522 Background: Breast cancer is the most common cancer in women worldwide. Both intrinsic and environmental factors contribute to the disparities in breast cancer incidence across different regions. In Hong Kong, the incidence has been increasing in the past decades. With over 4700 women diagnosed in 2019, breast cancer is responsible for 27% of all female cancers in Hong Kong. Apart from intrinsic non-modifiable risk factors, some risk factors are modifiable and may reduce cancer risk. Methods: We conducted a case-control study that involved breast cancer patients from the Hong Kong Breast Cancer Registry with matched healthy controls from the community between 2014 and 2017. A standardized written questionnaire was used through face-to-face interviews of all study participants. The questionnaire collected information on participants’ demographics, general health, smoking history and other lifestyle factors including physical activity, self-assessed dietary habits (balanced, vegetarian, meat and dairy-rich diets), self-perceived stress levels (measured with a 4-point Likert scale, and high stress level was defined as having over 50% of the participant’s time with stress being scored 3 or above out of a Likert scale of 4), body mass index, family history, menstrual and reproductive history, and history on the use of oral contraceptives and hormone replacement therapy. Multiple logistic regression was fitted to compare all risk factors. Results: A total of 5,186 breast cancer patients and 5,571 controls were recruited. Modifiable risk factors that were shown to be associated with an increased risk of breast cancer included self-perceived high stress level (adjusted odd ratios [aOR] = 3.44; 95% CI = 3.13-3.78), meat-rich diet (aOR = 1.77; 95% CI = 1.54-2.04), dairy-rich diet (aOR = 3.33; 95% CI = 2.01-5.52), overweight/obese status (aOR = 1.21; 95% CI = 1.10-1.32), delayed child-bearing (aOR = 2.23; 95% CI = 1.79-2.79), nulliparity (aOR = 1.21; 95% CI = 1.08-1.35) and ever use of oral contraceptives (aOR = 1.34; 95% CI = 1.22-1.47), while exercise (OR = 0.62; 95% CI = 0.56-0.68) and breast-feeding (aOR = 0.76; 95% CI = 0.69-0.83) were associated with reduced risk. Conclusions: In Hong Kong, high stress level, meat- and dairy- rich diet, overweight/obese, reproductive history and use of oral contraceptives were identified to be modifiable risk factors for breast cancer. Adjusting these factors through lifestyle modification may curb the increasing trend of breast cancer incidences in the coming decades.

A case-control study of 10,757 individuals to assess potentially modifiable risk factors, including stress, for breast cancer among Chinese patients in Hong Kong.

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Winnie Yeo

Papers

Abstract 4423: Novel therapeutic potential in targeting the microtubules by nanoparticle albumin-bound paclitaxel in hepatocellular carcinoma

Intracranial metastasis from nasopharyngeal carcinoma: Report of three cases and review of literature

Use of nanoparticles comprising a taxane and albumin in the treatment of hepatocellular carcinoma

A case-control study of 10,757 individuals to assess potentially modifiable risk factors, including stress, for breast cancer among Chinese patients in Hong Kong.

RE: Roles Played by Chemolipiodolization and Embolization in Chemoembolization for Hepatocellular Carcinoma: Single-Blind, Randomized Trial