Ginkgo biloba (EGb) is a widely used botanical drug with diverse biological properties. Several reports indicate that EGb confers both preventive effects as well as anti-tumorigenic properties in a variety of tumors, including hepatocellular carcinoma (HCC). We here evaluate the functional and mechanistic effects of EGb on human hepatocellular carcinoma cells as well as untransformed hepatocytes.
Primary liver cancers (PLCs) rank among the most lethal solid cancers worldwide due to lack of effective biomarkers for early detection and limited treatment options in advanced stages. While cell lines have been of significant impact for cancer research over the last decades, development of in vitro models that closely recapitulate phenotypic and molecular diversity of the primary cancers is urgently needed to improve the outcome of patients.
Resistance to cell death is a hallmark of many cancers including hepatocellular carcinoma (HCC). The chronic inflammatory microenvironment within liver predisposes HCC development and progression. Herein, tumor predisposition to apoptosis is reflected by the dynamic distribution of the pro-apoptotic BCL-2 proteins BAX/BAK between cytosol and mitochondria. However, underlying molecular mechanisms that maintain this equilibrium during hepatocarcinogenesis remain elusive.
Introduction Incidence and mortality of cholangiocarcinoma (CCA) have been rising globally. Real world data on the overall survival (OS) of patients receiving sequential palliative chemotherapy (pCTX) are lacking. Moreover, evidence about therapeutic options and their efficacy following the standard-of-care first- and second-line therapy with gemcitabine/cisplatin and FOLFOX is limited.
Regorafenib is one option for second-line treatment of hepatocellular carcinoma (HCC), improving overall survival (OS) of sorafenib-tolerant patients who develop progression. We aim to evaluate the safety and outcomes of regorafenib as second-line treatment for HCC recurrence after liver transplantation (LT). This is a retrospective, multicenter, international study including regorafenib-treated LT patients (2015-2018), with analysis of baseline characteristics and evolutionary events during sorafenib/regorafenib treatment. Twenty-eight LT patients (57 years, 7% cirrhotics, 54% performance status 1) were included. Median time from LT to regorafenib initiation was 3.9 (1.1-18.5) years; median time on sorafenib was 11.3 (0.7-76.4) months and 14 (1-591) days from sorafenib discontinuation to regorafenib. During regorafenib (6.3 months), all patients had at least one adverse event (AE), the most common grade 3/4 AEs were fatigue (n = 7) and dermatological reaction (n = 5). While no liver rejection was observed, plasma levels of immunosuppressive drugs increased in five. Twenty-four patients developed progression (38% extrahepatic growth, 33% new extrahepatic lesions/vascular invasion). Median OS from regorafenib initiation was 12.9 (95% CI, 6.7-19.1) and 38.4 months (95% CI, 18.5-58.4) for the sorafenib initiation. This is the first study showing safety of regorafenib after LT, thus providing the rational of considering regorafenib in the clinical decision-making in sorafenib-tolerant patients with HCC recurrence after LT.
Hepatocellular carcinoma is one of the most lethal cancers worldwide. Novel prognostic and/or predictive biomarkers are urgently needed to improve patient management. Alpha-fetoprotein is a well-established and widely used biomarker for hepatocellular carcinoma. However, diagnostic accuracy of static alpha-fetoprotein values is limited and the clinical potential is a matter of ongoing scientific discussion.
Hepatocellular Carcinoma (HCC) is a leading cause of death in cirrhotic patients and ranks among the most lethal cancers worldwide. Novel biomarkers for early detection and accurate prediction of prognosis are urgently needed to improve patient management. Alpha-fetoprotein (AFP) is a well-established and widely used biomarker for HCC. However, diagnostic accuracy of “static” AFP-values is limited and clinical potential as a prognostic and/or predictive marker needs to be more precisely defined. Therefore, we evaluated the prognostic impact of pre-treatment serum AFP dynamics on the overall survival (OS) of HCC-patients in a German cohort.
Background and Aims: The multikinase inhibitor cabozantinib has been approved for hepatocellular carcinoma (HCC) previously treated with sorafenib. We report safety and efficacy data of an international, multicenter, real-life cohort of patients with advanced HCC treated with cabozantinib. Methods: Patients with HCC who were treated with cabozantinib were retrospectively identified across 11 centers in Austria, Switzerland, and Germany. Patients’ characteristics, adverse events, duration of treatment and overall survival (OS) data were analyzed until April 1, 2020. Results: Eighty-eight patients from 11 centers were included. The predominant underlying liver diseases were NAFLD/NASH in 26 (30%) and hepatitis C infection in 21 (24%) patients. Seventy-eight patients (89%) were classified as Barcelona clinic liver cancer (BCLC) stage C. Sixty patients (68%) were Child-Pugh A, whereas 22 (25%) were Child-Pugh B, respectively. Cabozantinib was used as systemic second- and third-line or later treatment in 41 (47%) and 46 (52%) patients, respectively. The following best responses under cabozantinib were documented: partial response in 6 (7%), stable disease in 28 (32%), and progressive disease in 28 (32%) patients, respectively. Fifty-two patients (59%) died during follow-up. The median OS from start of cabozantinib treatment was 7.0 months in the entire cohort and 9.7 months in Child-Pugh A patients, while Child-Pugh B patients had a median OS of 3.4 months, respectively. Thirty-seven (42%) patients fulfilled the CELESTIAL inclusion and exclusion criteria, showing a median OS of 11.1 months. Most common adverse events were fatigue (15.6%) and diarrhea (15.6%). Conclusion: Cabozantinib treatment was effective, safe, and feasible in patients with advanced HCC in patients with compensated cirrhosis. Patients in the real-life setting had more advanced liver disease – in which 25% of patients were Child-Pugh B. However, OS in patients with Child-Pugh A cirrhosis was similar to that reported in the phase 3 trial (CELESTIAL).
