Mar 20, 2018

Dear colleagues,

Worldwide interest in HCC continues to grow. In 2017 Pubmed recorded over 7000 articles in which HCC was a keyword. Of these about 10% were reviews. Of course, some of these publications were in low impact journals and would not be expected to change practice in any meaningful way. However, there was at last one major clinical advance, with positive results coming from the cabozantinib trial. There are now 5 agents that are either licensed or will be, that can be used for the management of HCC. The big question will be whether these agents can be combined and if so how should they be combined or used sequentially. On the basic science side, there were many articles exploring the genetics of HCC and the expression profile of these cancers. The tumour (and liver) microenvironment was also the subject of intensive investigation.

Non-alcoholic fatty liver disease has a complex relationship with hepatocellular carcinoma. Many investigators, both in the laboratory and in the clinic are trying to get to grips with these complexities to understand how fatty liver predisposes to HCC, and from a clinical standpoint, how to define who is at risk for HCC and how to provide surveillance. New surveillance algorithms that do not necessarily include ultrasonography are required.

Contrast ultrasound agents are now available in the USA, bringing ultrasound in the US into the 21st century. It is a mystery that contrast US has been widely available elsewhere for years, but only recently in the US. In response the LI-RADS group has developed specific reporting tools for liver masses interrogated by contrast ultrasound.

At ILCA, the Executive Committee is exploring new ways to improve our “product”, to provide more services to our members and to the liver cancer community in general. More on this in future columns as these projects move to fruition.

Best wishes and regards to all,

Morris Sherman