Researchers around the world are looking at better ways to prevent, diagnose and treat primary liver cancer.
If you are looking for a trial for liver cancer in the UK, go to Cancer Research UK’s clinical trials database. You need to talk to your specialist if there are any trials that you think you might be able to take part in.
Research is going on all around the world looking at ways to prevent liver cancer developing.
Long term infections of the hepatitis B and C viruses can cause scarring of the liver (cirrhosis) and primary liver cancer (hepatocellular cancer). So for many years research has looked into vaccines to prevent infection from these viruses. Studies have shown that the hepatitis B vaccine has resulted in a decrease of liver cancer in countries where the virus is common, such as Taiwan.
In the UK, children now have the hepatitis B vaccine as part of the childhood vaccination programme. And people at high risk of hepatitis B can also have the vaccine.
Researchers are currently developing a hepatitis C vaccine.
Researchers, governments and charities are also looking at ways to reduce other risk factors for cancers, including liver cancer, such as alcohol, smoking and obesity.
Some people at high risk of developing liver cancer may have screening for the disease. This is usually with an ultrasound scan. You may also have a blood test for a biomarker called AFP (alpha fetoprotein). Some people with HCC have a higher than normal level. But AFP can be raised for reasons other than cancer.
Researchers are looking for other biomarkers that may be more accurate in diagnosing liver cancer at an early stage. One of these is DKK1. Research has been promising so far, but more studies are needed to see how useful it is.
Surgery gives the best chance of curing liver cancer. Unfortunately many people with liver cancer are unable to have surgery because they are too unwell or the cancer is too advanced.
Surgeons are always looking into ways of developing surgical techniques to make it more effective, safer, and to improve recovery and quality of life for people after the operation.
The traditional way of doing surgery to remove part of the liver (liver resection) is to make a large cut in your tummy (abdomen). Another way is to make several small cuts in your abdomen. The surgeon removes the part of your liver with cancer through one of these cuts. This is called keyhole or laparoscopic surgery.
Researchers are comparing these two ways of doing surgery. They want to find out if there is a difference in the length of recovery time and how it affects your general well being.
Reducing the risk of cancer coming back after surgery
After surgery to remove the cancer, there is still a risk that the cancer may come back (recurrence). The risk of this happening depends on different factors including what the tumour looks like, and if the cancer had started to grow into blood vessels of the liver.
Researchers are still looking at ways to best predict someone’s risk of recurrence, for example learning more about the genetics of liver cancer cells.
Research so far has not found a treatment to give after surgery for liver cancer that helps people to live longer. But researchers around the world continue to look into this. They hope newer drugs, such as targeted cancer drugs, may help.
Targeted cancer drugs
This is an area that has developed a lot in recent years.
Targeted cancer drugs change the way that cells work, for example, they can block signals that tell cells to grow. There are different types of targeted cancer drugs including tyrosine kinase inhibitors (TKIs).
Immunotherapies can boost the body's own immune system to fight cancer cells.
Doctors already use some targeted cancer drugs in the treatment of liver cancer, including sorafenib, lenvatinib and regorafenib. You usually have them to treat advanced liver cancer. Researchers continue to study these drugs by using them with other treatments and to learn more about the side effects.
An immunotherapy drug called nivolumab has shown promising results. Trials are now comparing nivolumab with sorafenib as a first treatment for advanced liver cancer.
Researchers are looking at other targeted cancer drugs and immunotherapy for primary liver cancer, including;
Researchers are studying the best way of giving these types of drugs, in what combination and when, and if they can be used with other treatments for liver cancer.
Cancer vaccines are a type of immunotherapy. They help the immune system to recognise and attack cancer cells. One type of vaccine is made from dendritic cells. These are a type of white blood cell. One trial (called ImmunoTACE) is looking at whether it is helpful to give this cancer vaccine with chemotherapy and chemoembolisation (TACE) for liver cancer.
Doctors are looking into different ways of giving radiotherapy for liver cancer, for example stereotactic body radiotherapy (SBRT). This type of radiotherapy gives very precise doses to the cancer, and much less to surrounding healthy tissue. It is available in some centres as part of the NHS Commissioning through Evaluation programme.
Doctors are also looking at giving a type of internal radiotherapy called selective internal radiation therapy (SIRT) for liver cancer that can’t be removed with surgery. It is also called radioembolisation.
Research is also looking at some other types of treatment. They include:
- non thermal high energy pulses of electricity - this is also called irreversible electroporation (IRE). It gives short pulses of electricity to the tumour causing less damage to the surrounding tissue
- high intensity focused ultrasound (HIFU) - this uses high frequency sound waves to heat and destroy the tumour