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Hepatobiliary Cancer

Individuals of Mexican Descent May Have Higher Risk of Liver Cancer With Each Successive Generation

Studies show that Hispanic individuals have higher incidence rates of developing liver cancer and higher mortality rates—by 50% or more—than non-Hispanic White individuals for several cancers, including liver cancer. A new study investigating hepatocellular carcinoma among successive generations of ...

hepatobiliary cancer

Richard S. Finn, MD, on Hepatocellular Carcinoma: Recent Data on Lenvatinib Plus Pembrolizumab

Richard S. Finn, MD, of the Geffen School of Medicine at the University of California, Los Angeles, discusses primary phase III results from the LEAP-002 study of pembrolizumab, an anti–PD-1 therapy, plus lenvatinib, the orally available multiple receptor tyrosine kinase inhibitor, vs lenvatinib monotherapy in patients with advanced hepatocellular carcinoma (Abstract LBA34).

Hepatobiliary Cancer
Immunotherapy

FDA Approves Durvalumab-Based Combination for Locally Advanced or Metastatic Biliary Tract Cancer

On September 2, the U.S. Food and Drug Administration (FDA) approved durvalumab (Imfinzi) in combination with gemcitabine and cisplatin for adult patients with locally advanced or metastatic biliary tract cancer. TOPAZ-1 Efficacy was evaluated in TOPAZ-1 (ClinicalTrials.gov identifier:...

Hepatobiliary Cancer
Genomics/Genetics

Study Examines How Genetic Mutations May Contribute to the Development of Cholangiocarcinoma

A team of researchers from the University of Rochester discovered how certain genetic mutations fuel the growth of cholangiocarcinoma, a rare but aggressive type of malignancy that has been on the rise in the United States. Their work, published by Guo et al in Cell Reports this week, details the...

Hepatobiliary Cancer

Does Exposure to 'Forever Chemical' Elevate Risk of Developing Hepatocellular Carcinoma?

Exposure to a synthetic chemical found widely in the environment may be linked to the development of nonviral hepatocellular carcinoma, according to a new study published by Goodrich et al in JHEP Reports. The chemical—called perfluorooctane sulfate, or PFOS—is one of a class of man-made chemicals...

Hepatobiliary Cancer

Addition of Transarterial Chemoembolization to Lenvatinib in First-Line Treatment of Advanced Hepatocellular Carcinoma

An interim analysis of the Chinese phase III LAUNCH trial was reported in the Journal of Clinical Oncology by Peng et al. The researchers found that the addition of transarterial chemoembolization to lenvatinib improved overall survival in patients with advanced hepatocellular carcinoma who were...

Hepatobiliary Cancer
Genomics/Genetics

Study Sheds Light on Mechanisms Driving Cancer Induced by Organic Solvent Used in Printing Industry

1,2-Dichloropropane (1,2-DCP) is a synthetic organic solvent used in the printing industry. It was linked to cholangiocarcinoma in 2013, when printing company employees in Osaka, Japan, exposed to 1,2-DCP were diagnosed with the cancer. Thereafter, the International Agency for Research on Cancer...

Hepatobiliary Cancer

Downstaging Hepatocellular Carcinoma Prior to Liver Transplant: 10-Year Outcomes

In some patients with hepatocellular carcinoma, downstaging of disease to within criteria that qualify the patient for a liver transplant leads to excellent 10-year posttransplant outcomes, according to new research published by Tabrizian et al in JAMA Surgery. The results validate current national ...

Hepatobiliary Cancer

Phase III Trial of Cabozantinib and Atezolizumab vs Sorafenib in Advanced Hepatocellular Carcinoma

As reported in The Lancet Oncology by Robin Kate Kelley, MD, and colleagues, the phase III COSMIC-312 trial has shown improved progression-free survival with cabozantinib plus atezolizumab vs sorafenib in patients with advanced hepatocellular carcinoma; interim analysis of overall survival showed...

Hepatobiliary Cancer

Study Links Sugar-Sweetened Beverage Consumption and Liver Cancer Risk

A study of more than 90,000 postmenopausal women found that those who consumed at least one sugar-sweetened beverage daily faced a 78% higher risk of developing liver cancer compared with people who consumed less than three servings per month of such beverages. These findings were presented by Zhao ...

hepatobiliary cancer
immunotherapy

Akihiro Ohba, MD, on Biliary Tract Cancer: New Findings on Fam-Trastuzumab Deruxtecan-nxki

Akihiro Ohba, MD, of Japan’s National Cancer Center Hospital, discusses phase II data from the HERB trial on fam-trastuzumab deruxtecan-nxki, which showed activity in patients with HER2-expressing unresectable or recurrent biliary tract cancer (Abstract 4006).

Hepatobiliary Cancer

Radiation Segmentectomy for Very Early– and Early-Stage Hepatocellular Carcinoma

Radiation segmentectomy may be an effective treatment for very early– to early-stage hepatocellular carcinoma (HCC) that cannot be treated surgically or thermally. The findings from a multidisciplinary study by researchers at the Icahn School of Medicine at Mount Sinai were published by Kim et al...

Hepatobiliary Cancer

Hepatic Arterial Infusion Pump Chemotherapy vs Resection for Multifocal Intrahepatic Cholangiocarcinoma

In a cohort study reported in JAMA Surgery, Franssen et al found little difference in median overall survival with hepatic arterial infusion pump (HAIP) floxuridine chemotherapy vs resection in patients with multifocal intrahepatic cholangiocarcinoma. Study Details The study population consisted of ...

Hepatobiliary Cancer
Pancreatic Cancer
Immunotherapy
Genomics/Genetics

Ipilimumab/Nivolumab in Patients With Metastatic Pancreatic or Biliary Cancer and HRD Pathogenic Germline Variants

In a single-institution case series reported in a research letter in JAMA Oncology, Terrero et al found that the combination of ipilimumab and nivolumab was active in patients with chemotherapy-refractory metastatic pancreatic or biliary cancer with homologous recombination deficiency (HRD)...

Hepatobiliary Cancer
Gastroesophageal Cancer
Genomics/Genetics

Assessment of Cancer Risk Profile for Germline BRCA1 and BRCA2 Pathogenic Variants in Patients With Common Cancers

In a Japanese case-control study reported in JAMA Oncology, Momozawa et al found that germline BRCA1/2 pathogenic variants were associated with an increased risk of biliary tract, esophageal, and gastric cancers, in addition to an increased risk of cancers that have well-established associations...

Hepatobiliary Cancer

Long-Term Survival Outcomes With Adjuvant Capecitabine in Biliary Tract Cancer

As reported in the Journal of Clinical Oncology by Bridgewater et al, long-term follow-up of the phase III BILCAP study has shown a continued survival benefit with adjuvant capecitabine therapy in patients with curatively resected biliary tract cancer. In the multicenter trial, 447 patients with...

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Anthony El-Khoueiry, MD

Anthony El-Khoueiry, MD, Member of the Section of Gastrointestinal Cancers, Director of the phase I program, and Associate Professor of Clinical Medicine at the Keck School of Medicine of the University of Southern California and USC Norris Comprehensive Cancer Center, said the findings of the...

Hepatobiliary Cancer
Immunotherapy

HIMALAYA Trial: First-Line Tremelimumab Plus Durvalumab Improves Overall Survival in Unresectable Hepatocellular Carcinoma

Patients with advanced, unresectable hepatocellular carcinoma may be gaining another first-line treatment option. In the global phase III HIMALAYA trial, a single priming dose of tremelimumab plus regular-interval durvalumab significantly improved overall survival, according to Ghassan K....

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Ian Chau, MD

Invited discussant Ian Chau, MD, Consultant Medical Oncologist at The Royal Marsden Hospital in London and Surrey in the United Kingdom, said the findings from COSMIC-312 are not mature enough to establish cabozantinib/atezolizumab as a new front-line option for advanced hepatocellular carcinoma...

Hepatobiliary Cancer
Immunotherapy

COSMIC-312: Cabozantinib Plus Atezolizumab Improves Progression-Free Survival in Advanced Hepatocellular Carcinoma

The phase III COSMIC-312 study has met its primary endpoint, showing a significant improvement in progression-free survival with cabozantinib plus atezolizumab compared with sorafenib in treatment-naive hepatocellular carcinoma (HCC), investigators reported at a European Society for Medical...

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Chris Verslype, MD, PhD

The invited discussant of the RATIONALE 208 trial, Chris Verslype, MD, PhD, Professor of Medicine at University Hospitals Leuven in Belgium, said tislelizumab is an “active and safe” investigational PD-1 antibody, “comparable to other PD-1 agents.” In particular, he noted, the results of RATIONALE...

Hepatobiliary Cancer
Immunotherapy

RATIONALE 208: ‘Durable Clinical Activity’ Reported With Tislelizumab in Advanced Liver Cancer

With the investigational checkpoint inhibitor tislelizumab, durable responses were achieved by some patients with previously treated advanced hepatocellular carcinoma, regardless of the number of prior lines of therapy, in the phase II RATIONALE 208 trial. These findings were presented during the...

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Nilofer Azad, MD

Nilofer Azad, MD, Professor of Oncology at Johns Hopkins University School of Medicine and Co-Director of Cancer Genetics and Epigenetics at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, was invited to discuss the results of the phase III TOPAZ-1 study, which found an overall survival...

Hepatobiliary Cancer
Immunotherapy

TOPAZ-1: Overall Survival Prolonged With First-Line Immunotherapy Plus Chemotherapy in Biliary Tract Cancer

For the first time, a phase III study has shown an overall survival benefit for upfront treatment using immunotherapy plus chemotherapy in advanced biliary tract cancer. In the TOPAZ-1 trial, the addition of the anti–PD-L1 agent durvalumab to gemcitabine plus cisplatin significantly improved...

Hepatobiliary Cancer

Ivosidenib vs Placebo for Previously Treated Advanced IDH1-Mutated Cholangiocarcinoma: Final Overall Survival Analysis of the ClarIDHy Trial

As reported in JAMA Oncology by Andrew X. Zhu, MD, PhD, and colleagues, the final overall survival analysis of the pivotal phase III ClarIDHy trial showed prolonged overall survival with ivosidenib vs placebo in previously treated patients with unresectable or metastatic cholangiocarcinoma and an...

Colorectal Cancer
Hepatobiliary Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer
Immunotherapy

Recent FDA Approvals in Gastrointestinal Cancer

Over the past year, the U.S. Food and Drug Administration granted approval to several novel drugs and new indications for older therapeutic agents used in gastrointestinal oncology. Cetuximab Plus Encorafenib On September 28, 2021, cetuximab (Erbitux) was approved in combination with encorafenib...

Hepatobiliary Cancer
Immunotherapy

Sequencing of Drug Combinations Could Amplify Antitumor Immune Response in Liver Cancer

A new therapeutic strategy for hepatocellular carcinoma (HCC) that initially primes the tumor with an immune checkpoint inhibitor before using a multikinase inhibitor has shown efficacy in a study published in the Journal of the National Cancer Institute. Kikuchi et al reported that the new...

Hepatobiliary Cancer

Characteristics of Nonalcoholic Fatty Liver Disease–Related HCC vs HCC From Other Causes

In a meta-analysis reported in The Lancet Oncology, Tan et al found that patients with nonalcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma (HCC) were more likely to have metabolic/cardiovascular comorbidity, less likely to have cirrhosis, and less likely to undergo...

Hepatobiliary Cancer

ASTRO Issues Clinical Guideline on External-Beam Radiation Therapy for Primary Liver Cancers

A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance on the use of external-beam radiation therapy (EBRT) to treat adults with primary liver cancers. The guideline, ASTRO’s first for primary liver cancers, is published in Practical Radiation ...

Hepatobiliary Cancer

Study Evaluates Effectiveness of Existing Risk Stratification System for Hepatoblastoma

A new study published by Zhou et al in JAMA Network Open independently verified the value of a system that assesses hepatoblastoma risk in children. The researchers also discovered the potential for tumor histology to predict a patient’s hepatoblastoma prognosis.  Hepatoblastoma is a rare childhood ...

Hepatobiliary Cancer

H1-Antihistamine Use and Risk of Hepatocellular Carcinoma in Persons With Hepatitis B Virus, Hepatitis C Virus, or Dual Infection

In a Taiwanese study reported in the Journal of Clinical Oncology, Shen et al found that use of H1-antihistamines was associated with reduced risk of hepatocellular carcinoma in patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or dual HBV/HCV infection. Study Details The study...

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Anthony El-Khoueiry, MD

Anthony El-Khoueiry, MD, Member of the Section of Gastrointestinal Cancers, Director of the phase I program, and Associate Professor of Clinical Medicine at the Keck School of Medicine of the University of Southern California and USC Norris Comprehensive Cancer Center, said the findings of the...

Hepatobiliary Cancer
Immunotherapy

HIMALAYA Trial: First-Line Tremelimumab Plus Durvalumab Improves Overall Survival in Unresectable Hepatocellular Carcinoma

Patients with advanced, unresectable hepatocellular carcinoma may be gaining another first-line treatment option. In the global phase III HIMALAYA trial, a single priming dose of tremelimumab plus regular-interval durvalumab significantly improved overall survival, according to Ghassan K....

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Nilofer Azad, MD

Nilofer Azad, MD, Professor of Oncology at Johns Hopkins University School of Medicine and Co-Director of Cancer Genetics and Epigenetics at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, was invited to discuss the results of the phase III TOPAZ-1 study, which found an overall survival...

Hepatobiliary Cancer
Immunotherapy

TOPAZ-1: Overall Survival Prolonged With First-Line Immunotherapy Plus Chemotherapy in Biliary Tract Cancer

For the first time, a phase III study has shown an overall survival benefit for upfront treatment using immunotherapy plus chemotherapy in advanced biliary tract cancer. In the TOPAZ-1 trial, the addition of the anti–PD-L1 agent durvalumab to gemcitabine plus cisplatin significantly improved...

hepatobiliary cancer

Anthony B. El-Khoueiry, MD, on Hepatocellular Carcinoma: Expert Perspective on Novel Additive Strategies

Anthony B. El-Khoueiry, MD, of the University of Southern California, Norris Comprehensive Cancer Center, discusses two key phase III studies of first-line treatment in hepatocellular carcinoma: the LAUNCH trial, which explored lenvatinib combined with transarterial chemoembolization for advanced disease; and the HIMALAYA trial, which studied tremelimumab and durvalumab for unresectable disease. The latter trial may represent a new standard of care, according to Dr. El-Khoueiry.  

hepatobiliary cancer
immunotherapy

Ghassan K. Abou-Alfa, MD, MBA, on Hepatocellular Carcinoma: Open-Label Trial of Tremelimumab and Durvalumab

Ghassan K. Abou-Alfa, MD, MBA, of Memorial Sloan Kettering Cancer Center and Weill Medical College at Cornell University, discusses phase III results of the HIMALAYA trial, which showed the combination of a single priming dose of tremelimumab added to durvalumab is superior to sorafenib for patients with unresectable hepatocellular carcinoma (Abstract 379).

hepatobiliary cancer
immunotherapy

Nilofer Saba Azad, MD, on Novel Treatment Combinations Under Study in Biliary Tract Cancers

Nilofer Saba Azad, MD, of Johns Hopkins Sidney Kimmel Cancer Center, assesses the findings from the phase III TOPAZ-1 trial, a study of durvalumab in combination with gemcitabine plus cisplatin in patients with advanced biliary tract cancer. Dr. Azad explains why the study sets a potential new standard of care of gemcitabine plus cisplatin and durvalumab in unselected patients.

Hepatobiliary Cancer

Neoadjuvant Cemiplimab-rwlc for Patients With Resectable Hepatocellular Carcinoma

In a single-institution phase II trial reported in The Lancet Gastroenterology & Hepatology, Marron et al found that neoadjuvant treatment with the PD-1 inhibitor cemiplimab-rwlc in patients with resectable hepatocellular carcinoma produced a high level of pathologic tumor necrosis at resection ...

Hepatobiliary Cancer
Immunotherapy

Durvalumab/Tremelimumab Improves Overall Survival vs Sorafenib in Patients With Advanced Hepatocellular Carcinoma: HIMALAYA

Results from the randomized international phase III HIMALAYA trial showed that a combination of the anti–PD-L1 immunotherapy durvalumab plus the anti–CTLA-4 immunotherapy tremelimumab reduced the risk of death by 22% in patients with stage III or IV unresectable hepatocellular carcinoma compared to ...

Hepatobiliary Cancer
Immunotherapy

Durvalumab Plus Gemcitabine/Cisplatin Improves Survival in Patients With Advanced Biliary Tract Cancer: TOPAZ-1

Biliary tract cancer is a rare and often fatal disease comprised primarily of bile duct and gallbladder cancers; it is diagnosed in about 12,000 individuals each year in the United States. The cancer has a 5-year relative survival rate of 25% for localized intrahepatic bile duct cancers and just...

Hepatobiliary Cancer

ASTRO Issues Clinical Guideline on External-Beam Radiation Therapy for Primary Liver Cancers

A clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance on the use of radiation therapy to treat adult patients with primary liver cancers using external-beam radiation therapy (EBRT). Evidence-based recommendations outline indications and optimal EBRT...

Hepatobiliary Cancer
Genomics/Genetics

European Genome-Wide Association Study of Genetic Variants in Alcohol-Related Hepatocellular Carcinoma

In a case-control genome-wide association study among persons of European ancestry reported in The Lancet Oncology, Trépo et al identified common genetic variants associated with the risk of alcohol-related hepatocellular carcinoma (HCC). Study Details The study involved a discovery cohort of 2,107 ...

Hepatobiliary Cancer

Hepatic Arterial Infusion Chemotherapy vs Sorafenib for Advanced Hepatocellular Carcinoma

In a Chinese phase III trial (FOHAIC-1) reported in the Journal of Clinical Oncology, Lyu et al found that hepatic arterial infusion chemotherapy with FOLFOX (fluorouracil, leucovorin, and oxaliplatin; HAIC-FO) significantly prolonged overall survival vs sorafenib in patients with advanced...

Hepatobiliary Cancer
Immunotherapy

Expert Point of View: Ian Chau, MD

Invited discussant Ian Chau, MD, Consultant Medical Oncologist at The Royal Marsden Hospital in London and Surrey in the United Kingdom, said the findings from COSMIC-3121 are not mature enough to establish cabozantinib/atezolizumab as a new front-line option for advanced hepatocellular carcinoma...

Hepatobiliary Cancer
Immunotherapy

COSMIC-312: Cabozantinib Plus Atezolizumab Improves Progression-Free Survival in Advanced Hepatocellular Carcinoma

The phase III COSMIC-312 study has met its primary endpoint, showing a significant improvement in progression-free survival with cabozantinib plus atezolizumab compared with sorafenib in treatment-naive hepatocellular carcinoma (HCC), investigators reported at a European Society for Medical...

Hepatobiliary Cancer
Immunotherapy

First-Line Nivolumab vs Sorafenib in Advanced Hepatocellular Carcinoma: Effect on Overall Survival

As reported in The Lancet Oncology by Thomas Yau, MD, and colleagues, the phase III CheckMate 459 trial has shown no improvement in overall survival with first-line nivolumab vs sorafenib in patients with advanced hepatocellular carcinoma. Study Details In the open-label trial, 743 patients not...

Hepatobiliary Cancer

Impact of Small Cell Undifferentiated Histology on Outcomes in Pediatric Hepatoblastoma

In an analysis from the Children’s Oncology Group study AHEP0731 reported in the Journal of Clinical Oncology, Trobaugh-Lotrario et al found that the presence of small cell undifferentiated histology elements did not appear to adversely affect outcomes in pediatric patients with hepatoblastoma....

Hepatobiliary Cancer
Immunotherapy

Novel Vaccine Platform Plus Pembrolizumab May Boost Immune Response in Advanced HCC

A novel vaccine platform administered in combination with pembrolizumab appears to be safe and effective in patients with advanced hepatocellular carcinoma (HCC), according to data presented by Mark Yarchoan, MD, and colleagues at the Society for Immunotherapy of Cancer (SITC) 2021 Annual Meeting...

Hepatobiliary Cancer
Genomics/Genetics

Association of KRAS Variants With Outcomes After Curative Resection of Intrahepatic Cholangiocarcinoma

In a Chinese single-institution cohort study reported in JAMA Surgery, Zhou et al found that the presence of somatic G12 KRAS variants was associated with poorer overall and disease-free survival in patients who had undergone curative resection of intrahepatic cholangiocarcinoma. Study Details The ...

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