Docs on a quest to tailor liver cancer treatment- Research

November 27, 2012

A major clinical trial is being expanded in a bid to find ways to help liver cancer patients decide on the best treatment.

Doctors hope the research will prevent them being sent on a “wild goose chase” when treating an illness that behaves differently in each individual.

Liver cancer is one of the most deadly forms of the disease, with few patients surviving more than six months after being diagnosed.

The Singapore-led trial secured a record $10.2 million in funding two years ago from the Government and an Australian medical device company.

Its main aim is to determine which of two drugs for advanced liver cancer should be given to patients as a first-line drug in the clinic.

The research has now been extended to include a study on biomarkers – or proteins that can reveal whether people possess characteristics such as being insensitive to a particular drug. This could help patients decide which treatment best suits them.

Investigators will also be testing a new way to conduct medical scans of the liver and determining how long sufferers should wait before undergoing surgery.

The trial involves 360 patients in 13 countries. Researchers are now applying for more money to fund the expanded version, which was approved last week.

Professor Pierce Chow, who is leading the project, said the results could alter the way liver cancer is treated here and overseas.

The main trial involves patients being put on either sorafenib or SIR-Spheres.

Currently, there is no scientific consensus on which drug is better.

In the first of three extensions, researchers will test patients’ blood for biomarkers to find out which drug correlates with better survival rates.

In future, this could allow doctors to help patients select the most suitable treatment using just a simple blood test.

n the second new segment, patients will undergo positron emission tomography scans, where they are injected with a substance that shows up in the scan and can reveal the activity and location of the cancer cells.

Usually, glucose is used. But doctors have found that it is not that useful because it is broken down by the liver, meaning it may not show up clearly in the scans. So the researchers will try using another substance called choline.

The last investigation involves tracking how well the liver recovers after initial treatment such as chemotherapy to pinpoint when the patient is ready for surgery.

The organ must have resumed enough of its normal functions before an operation to cut off the diseased parts can be safely carried out. Otherwise, the patient may be left with a lack of healthy liver tissue.

Prof Chow said the trials were very important from the patient’s point of view as they could help future sufferers decide which treatment option is best for them. “This way, we won’t go on a wild goose chase.”

Few liver cancer patients survive longer than six months after diagnosis.

It is highly resistant to chemotherapy. Only one in five sufferers qualifies either for surgery to cut out the cancerous portion or a liver transplant.

About 400 people die of liver cancer here each year, according to data from the Singapore Cancer Registry.

Most are men, making it the fourth most common cancer in males.

Globally, the majority of cases occur in this part of the world. About 80 per cent of the one million deaths each year happen in the Asia-Pacific region.

Source: The Straits Times

Category: Education

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