- Email: [email protected]
Hepatocellular carcinoma recurrence after direct antiviral agent treatment: a european multicentric study
POSTER PRESENTATIONS Conclusions: Serial measurement of GALAD may permit early detection of recurrence. Changes in serum biomarkers are likely to be directly related to the primary tumour rather than stemming from a field change in the non-tumorous liver. References 1.
Johnson et al., Cancer Epidemiol Biomarkers Prev. 2014 Jan;23 (1):144–53 2. Berhane et al., Clinical Gastroenterology and Hepatology 2016;14:875–886 3. Lewis Robert’s 2016 EASL abstract
Conclusions: Serum AFP is a readily available, sensitive and objective prognostic indicator for HCC in its own right. Individual cut-off points resulting in simple dichotomisation of data waste much important clinical information. Acknowledgments: We are grateful to Bristol-Myers Squibb and Pfizer Inc. who generously gave us access to data from studies in which they acted as sponsor, and all those who contributed by collecting data at the above centres. SAT-079 Serum biomarker (‘GALAD’) response after resection of hepatocellular carcinoma: impact of tumour recurrence P.J. Johnson1,2, S. Berhane1, T. Tada3, H. Toyoda3, T. Kumada3. 1 Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool; 2The Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, United Kingdom; 3Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan E-mail: [email protected] Background and Aims: A serum-based tool (“GALAD”) for the detection of hepatocellular carcinoma (HCC) has been developed. The model is based on Gender, Age and three serological biomarkers, AFP, AFP-L3 and DCP1, all of which are commercially available on a single standard platform. The model has been extensively validated2,3. Methods: Serial data were available on 326 patients with HCC (82% solitary, median tumours size of 2.7 cm (IQR 1.8, 4.4), 62.3% HCV, 18.1% HBV, 19.6% other) undergoing surgical resection with curative intent. In 195 of these, there was recurrence within 3 years of resection, and in 131 there was no recurrence. Results: After resection, the GALAD score declined in all patients but the decline was most marked in those that had no recurrence by 3 years, reaching and remaining below the our reference range within 3 months of resection (figure). By contrast, among that group that had recurrent disease, after a more modest decline, the values increased steadily. The GALAD score was significantly different between the two groups at 9 months ( p < 0.0001). Those with recurrence tended to have higher degrees of fibrosis (as judged by their FIB-4 index) ( p = 0.0004) both at the time of resection 2.89 (IQR 2.13, 4.69) vs. 4.22 (IQR 2.73, 6.01) and subsequently.
SAT-080 Hepatocellular carcinoma recurrence after direct antiviral agent treatment: a european multicentric study P. Kolly1,2, O. Waidmann3, J. Vermehren3, C. Moreno4, T. Berg5, D. Semela6, S. Zeuzem3, J.-F. Dufour1,2. 1Hepatology, Department of Clinical Research, University of Bern; 2University Clinic of Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland; 3Department of Medicine I, Division of Gastroenterology and Hepatology, Johann Wolfgang Goethe University Hospital Frankfurt, Frankfurt, Germany; 4 Cliniques Universitaires de Bruxelles Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; 5Department of Internal Medicine, Neurology and Dermatology, Medical Clinic of Gastroenterology and Rheumatology, Section of Hepatology, University Hospital Leipzig, Leipzig, Germany; 6Division of Gastroenterology, Canton Hospital St Gallen, St Gallen, Switzerland E-mail: [email protected] Background and Aims: Since the introduction of new Direct Antiviral Agents (DAA) for hepatitis C virus, evidence has been published suggesting an increased rate of hepatocellular carcinoma recurrence after DAA therapy. The aim of this study is to explore the HCC recurrences after DAA therapy in patients having been treated for HCC in an international multicentric cohort and looking at possible cofactors. Methods: For this study, a multicentric cohort was built with patients treated in five different centers in Europe: University Hospital Frankfurt, Germany, Inselspital Bern, Switzerland, Erasmus Hospital Brussels, Belgium, University Hospital Leipzig, Germany and Canton Hospital St Gallen, Switzerland. We included patients that have been treated for their HCC prior to DAA therapy with surgical resection, ablation or transarterial (chemo-)embolization and who showed a radiological complete response before starting DAA treatment. Results: We included a total of 56 patients, 73.2% were men, median age was 61 (48–83), and the mean follow up time was 21.0 months after HCC treatment. HCC recurrence rate of 19% at 1 year and 44% at 2 years after HCC treatment. Anti-HBc positive serology ( p = 0.193), hepatitis C genotype ( p = 0.970) were not associated with HCC recurrence. Patients who had a longer timeframe between HCC treatment and DAA treatment were less at risk of developing a recurrence (HR 0.908, 95% CI 0.857–0.962, p = 0.001). Conclusions: An international multicentric cohort of HCC patients with complete radiological response before DAA treatment finds a HCC recurrence rate of 19% and 44% at 1 and 2 years, respectively. The timeframe between HCC treatment and DAA therapy is a predictor for recurrences. SAT-081 A 6 year single centre experience of automated surveillance for hepatocellular carcinoma T. Cross1, D. Yew1, N. Kibriya2, J. Evans2. 1Department of Hepatology; 2Department of Interventional Radiology, The Royal Liverpool Hospital, Liverpool, United Kingdom E-mail: [email protected] Background and Aims: Hepatocellular carcinoma (HCC) in western populations occurs mainly in cirrhosis. Liver ultrasound for surveillance for HCC aims to detect cancer at an early stage when patients have a better prospect of cure. But the role of surveillance is
Journal of Hepatology 2017 vol. 66 | S543–S750
S621
Johnson et al., Cancer Epidemiol Biomarkers Prev. 2014 Jan;23 (1):144–53 2. Berhane et al., Clinical Gastroenterology and Hepatology 2016;14:875–886 3. Lewis Robert’s 2016 EASL abstract
Conclusions: Serum AFP is a readily available, sensitive and objective prognostic indicator for HCC in its own right. Individual cut-off points resulting in simple dichotomisation of data waste much important clinical information. Acknowledgments: We are grateful to Bristol-Myers Squibb and Pfizer Inc. who generously gave us access to data from studies in which they acted as sponsor, and all those who contributed by collecting data at the above centres. SAT-079 Serum biomarker (‘GALAD’) response after resection of hepatocellular carcinoma: impact of tumour recurrence P.J. Johnson1,2, S. Berhane1, T. Tada3, H. Toyoda3, T. Kumada3. 1 Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool; 2The Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, Wirral, United Kingdom; 3Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan E-mail: [email protected] Background and Aims: A serum-based tool (“GALAD”) for the detection of hepatocellular carcinoma (HCC) has been developed. The model is based on Gender, Age and three serological biomarkers, AFP, AFP-L3 and DCP1, all of which are commercially available on a single standard platform. The model has been extensively validated2,3. Methods: Serial data were available on 326 patients with HCC (82% solitary, median tumours size of 2.7 cm (IQR 1.8, 4.4), 62.3% HCV, 18.1% HBV, 19.6% other) undergoing surgical resection with curative intent. In 195 of these, there was recurrence within 3 years of resection, and in 131 there was no recurrence. Results: After resection, the GALAD score declined in all patients but the decline was most marked in those that had no recurrence by 3 years, reaching and remaining below the our reference range within 3 months of resection (figure). By contrast, among that group that had recurrent disease, after a more modest decline, the values increased steadily. The GALAD score was significantly different between the two groups at 9 months ( p < 0.0001). Those with recurrence tended to have higher degrees of fibrosis (as judged by their FIB-4 index) ( p = 0.0004) both at the time of resection 2.89 (IQR 2.13, 4.69) vs. 4.22 (IQR 2.73, 6.01) and subsequently.
SAT-080 Hepatocellular carcinoma recurrence after direct antiviral agent treatment: a european multicentric study P. Kolly1,2, O. Waidmann3, J. Vermehren3, C. Moreno4, T. Berg5, D. Semela6, S. Zeuzem3, J.-F. Dufour1,2. 1Hepatology, Department of Clinical Research, University of Bern; 2University Clinic of Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland; 3Department of Medicine I, Division of Gastroenterology and Hepatology, Johann Wolfgang Goethe University Hospital Frankfurt, Frankfurt, Germany; 4 Cliniques Universitaires de Bruxelles Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; 5Department of Internal Medicine, Neurology and Dermatology, Medical Clinic of Gastroenterology and Rheumatology, Section of Hepatology, University Hospital Leipzig, Leipzig, Germany; 6Division of Gastroenterology, Canton Hospital St Gallen, St Gallen, Switzerland E-mail: [email protected] Background and Aims: Since the introduction of new Direct Antiviral Agents (DAA) for hepatitis C virus, evidence has been published suggesting an increased rate of hepatocellular carcinoma recurrence after DAA therapy. The aim of this study is to explore the HCC recurrences after DAA therapy in patients having been treated for HCC in an international multicentric cohort and looking at possible cofactors. Methods: For this study, a multicentric cohort was built with patients treated in five different centers in Europe: University Hospital Frankfurt, Germany, Inselspital Bern, Switzerland, Erasmus Hospital Brussels, Belgium, University Hospital Leipzig, Germany and Canton Hospital St Gallen, Switzerland. We included patients that have been treated for their HCC prior to DAA therapy with surgical resection, ablation or transarterial (chemo-)embolization and who showed a radiological complete response before starting DAA treatment. Results: We included a total of 56 patients, 73.2% were men, median age was 61 (48–83), and the mean follow up time was 21.0 months after HCC treatment. HCC recurrence rate of 19% at 1 year and 44% at 2 years after HCC treatment. Anti-HBc positive serology ( p = 0.193), hepatitis C genotype ( p = 0.970) were not associated with HCC recurrence. Patients who had a longer timeframe between HCC treatment and DAA treatment were less at risk of developing a recurrence (HR 0.908, 95% CI 0.857–0.962, p = 0.001). Conclusions: An international multicentric cohort of HCC patients with complete radiological response before DAA treatment finds a HCC recurrence rate of 19% and 44% at 1 and 2 years, respectively. The timeframe between HCC treatment and DAA therapy is a predictor for recurrences. SAT-081 A 6 year single centre experience of automated surveillance for hepatocellular carcinoma T. Cross1, D. Yew1, N. Kibriya2, J. Evans2. 1Department of Hepatology; 2Department of Interventional Radiology, The Royal Liverpool Hospital, Liverpool, United Kingdom E-mail: [email protected] Background and Aims: Hepatocellular carcinoma (HCC) in western populations occurs mainly in cirrhosis. Liver ultrasound for surveillance for HCC aims to detect cancer at an early stage when patients have a better prospect of cure. But the role of surveillance is
Journal of Hepatology 2017 vol. 66 | S543–S750
S621