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Innovations in Hepatocellular Carcinoma: Pathogenesis, Diagnosis, and Therapy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (30 December 2024) | Viewed by 1892

Special Issue Editor


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Guest Editor
Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, I-86100 Campobasso, Italy
Interests: hepatocellular carcinoma; MASLD; virus; immune checkpoint inhibitors; liquid biopsy

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) is the seventh most common cancer worldwide and the fourth leading cause of cancer death. Despite significant advances in diagnosis and treatment, the prognosis for patients with HCC remains poor, and it remains a significant global health challenge. This Special Issue delves into the latest advancements in understanding the pathogenesis, improving diagnosis, and developing innovative therapies for HCC.

In the first section, we review recent advances in our understanding of the molecular pathogenesis of HCC. This includes the identification of new genetic and epigenetic alterations that contribute to HCC development, as well as the role of immune cells in the tumor microenvironment. Notably, the identification of driver mutations in HCC has led to the development of targeted therapies that have shown promise in clinical trials. Additionally, research on the tumor microenvironment has revealed the importance of immune cells in HCC progression and has led to the development of novel immunotherapeutic approaches.

In diagnostics, the ai mis detects HCC at an early stage, when treatment is most likely to be curative. Imaging modalities, such as ultrasound, computed tomography, and magnetic resonance imaging, can be used to diagnose HCC and to monitor treatment response. Moreover, the integration of advanced imaging techniques, liquid biopsies, and multi-omics approaches has revolutionized the precise characterization of HCC. Emerging biomarkers, including circulating tumor DNA, microRNAs, and exosomal proteins, provide promising avenues for non-invasive screening and the real-time monitoring of disease progression and treatment response.

Therapeutically, the landscape of HCC management is rapidly evolving. This includes the use of targeted therapies, immunotherapy, and combination therapies. The advent of targeted therapies and immune checkpoint inhibitors has significantly improved patient outcomes such as lenvatinib, bevacizumab, atezolizumab, and durvalumab. Additionally, innovative approaches like CAR-T cell therapy, oncolytic virotherapy, and combination regimens are under investigation, aiming to overcome resistance mechanisms and enhance antitumor activity.

This Special Issue collates contributions from leading researchers and clinicians, providing comprehensive insights into the cutting-edge developments in HCC. By bridging the gap between basic research and clinical application, it aims to foster collaboration and accelerate the translation of scientific discoveries into effective therapies, ultimately improving prognosis and quality of life for HCC patients.

Prof. Dr. Luca Rinaldi
Guest Editor

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Keywords

  • hepatocellular carcinoma
  • MASLD
  • virus
  • immune checkpoint inhibitors
  • liquid biopsy

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Published Papers (1 paper)

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Research

11 pages, 642 KiB  
Article
Late Hepatocellular Carcinoma Occurrence in Patients Achieving Sustained Virological Response After Direct-Acting Antiviral Therapy: A Matter of Follow-Up or Something Else?
by Alessandro Perrella, Alfredo Caturano, Ilario de Sio, Pasquale Bellopede, Adelaide Maddaloni, Luigi Maria Vitale, Barbara Rinaldi, Andrea Mormone, Antonio Izzi, Costanza Sbreglia, Francesca Futura Bernardi, Ugo Trama, Massimiliano Berretta, Raffaele Galiero, Erica Vetrano, Ferdinando Carlo Sasso, Gianluigi Franci, Raffaele Marfella and Luca Rinaldi
J. Clin. Med. 2024, 13(18), 5474; https://doi.org/10.3390/jcm13185474 - 14 Sep 2024
Cited by 1 | Viewed by 1525
Abstract
Background: Despite achieving a sustained virological response (SVR) with direct-acting antivirals (DAAs), an unexpected increase in the occurrence rate of hepatocellular carcinoma (HCC) has been observed among HCV-treated patients. This study aims to assess the long-term follow-up of HCV patients treated with [...] Read more.
Background: Despite achieving a sustained virological response (SVR) with direct-acting antivirals (DAAs), an unexpected increase in the occurrence rate of hepatocellular carcinoma (HCC) has been observed among HCV-treated patients. This study aims to assess the long-term follow-up of HCV patients treated with DAAs who achieved an SVR to investigate the potential for late-onset HCC. Methods: In this prospective multicenter study, we enrolled consecutive HCV patients treated with DAAs following Italian ministerial guidelines between 2015 and 2018. Exclusion criteria included active HCC on imaging, prior HCC treatment, HBV or HIV co-infection, or liver transplant recipients. Monthly follow-ups occurred during treatment, with subsequent assessments every 3 months for at least 48 months. Abdominal ultrasound (US) was performed within two weeks before starting antiviral therapy, supplemented by contrast-enhanced ultrasonography (CEUS), dynamic computed tomography (CT), or magnetic resonance imaging (MRI) to evaluate incidental liver lesions. Results: Of the 306 patients completing the 48-months follow-up post-treatment (median age 67 years, 55% male), all achieved an SVR. A sofosbuvir-based regimen was administered to 72.5% of patients, while 20% received ribavirin. During follow-up, late-onset HCC developed in 20 patients (cumulative incidence rate of 6.55%). The pattern of HCC occurrence varied (median diameter 24 mm). Multivariate and univariate analyses identified liver stiffness, diabetes, body mass index, and platelet levels before antiviral therapy as associated factors for late HCC occurrence. Conclusions: Our findings suggest that late HCC occurrence may persist despite achieving SVR. Therefore, comprehensive long-term follow-up, including clinical, laboratory, and expert ultrasonography evaluations, is crucial for all HCV patients treated with DAAs. Full article
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