Researchers from The University of Texas MD Anderson Cancer Center (MD Anderson CC) will be presenting results from the largest single-center study looking at the clinical variations that exist among patients with the most common type of liver cancer called hepatocellular carcinoma (HCC), depending on the viral cause of the disease, either hepatitis B virus (HBV) or hepatitis C virus (HCV). The study findings, which suggest that differences in the viral origin of hepatitis status should be considered when developing treatment plans for newly diagnosed HCC patients, will be presented on May 31 in an oral abstract during the 2015 Annual Meeting of the American Society of Clinical Oncology (ASCO).
The research findings that will be presented at ASCO are built upon earlier studies conducted by the researchers in which they looked at outcomes among patients with inoperable HCC by demographics, geographical distribution and risk factors, including hepatitis status. They observed significant differences in patient outcomes based on demographics and geographic distribution (Asia versus Europe and USA) among patients receiving the same treatment protocol. The researchers then hypothesized that these differences might be attributed to variations with regard to hepatitis type, among other factors.
To test this hypothesis, the researchers investigated the characteristics of 815 HCC patients who were treated at MD Anderson between 1992 and 2011. They analyzed disease characteristics, survival rates, co-morbidities, and demographics of patients with both HBV and HCV. HBV is a DNA virus and HCV is an RNA virus, and the aim of the study was to assess if the differences in viral components would equate to a difference in clinical and pathological features of HCC and patient outcomes.
The results showed that patients with HBV are more likely to develop HCC at a younger age than HCV patients and presented more aggressive disease, pronounced by:
- Advanced diagnosis stage (3-6)
- High alpha-fetoprotein, a cancer signal and measure of how well treatments are working
- Poorly differentiated tumor cells, which tend to grow and spread more quickly
- Larger tumor size
- Extent of cancer in the liver ( >50% of the liver volume), a factor for metastases
- Portal thrombosis, a blockage or narrowing of the vessel that brings blood to the liver from the intestines.
While patients with HCV-associated HCC were more likely to exhibit the following:
- Underlying cirrhosis
- Have a history of greater alcohol and cigarette use
- A higher rate of diabetes
Another important finding showed a difference in the median survival rate for patients by viral origin, in which patients with HCV had a 10.9 month median survival rate in comparison to that of 9.3 months for patients with HBV.
Dr. Kaseb continued,”eligibility for certain treatments depends on cancer staging at diagnosis. Thus, this study has major implications for determining how we treat new HCC patients. Especially for patients with HBV, we need to determine if more aggressive treatment is warranted at the outset.”